356 Transcript: Parenting Anxious Kids and Teens: Advice from a Psychologist Mom// Dr. Terri Bacow

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Rachel: Terri, welcome to 3 in 30. I am so excited to talk with you today.

Dr. Terri Bacow: I am too. Thank you for having me.

Rachel: Well, this is a personal topic for me because I struggle with anxiety and just in the last few months, my daughter has started to sort of show some symptoms of anxiety. And it’s hard for me to know how much of that is just normal development and or if it is something to get more support for. We’re going to talk about that more in the interview, but it just feels like this is a very timely episode for me, personally. And so how cool is it that I have a job where I get to talk to an expert, pick your brain, for something that’s gonna help me in my own life, and then also share it with all of these moms.So, I’m just very thrilled to have here sharing your expertise with us on this topic.

Dr. Terri Bacow: So sounds like the timing is good.

Rachel: Yes, the timing is very good. So, , we are gonna be talking about anxiety -how to support , our anxious kids and teenagers, and this is your area of expertise. So why don’t we just jump right in with your first takeaway.

Dr. Terri Bacow: Sure. So my first takeaway is when you have a child who is anxious, they’re going to be irrational, and we, even if we are anxious, we might not share. Kind of what they’re coming with. But regardless of that, the first takeaway is that you must validate feelings before you can change behavior. You really have to acknowledge and validate anxious feelings. And the way that we do that is by letting the child know that we hear them, that we understand. And you know, not all feelings are warranted or justified, but they’re always understandable.

Rachel: Hmm.

Dr. Terri Bacow: So we need to say to our anxious kids, that’s so frustrating. You know, this must be really hard for you right now. And to really reflect what they’re coming to us with, that’s the only way that they’re going to calm down enough. To be able to work with you to kind of reframe or get out of the situation or be brave.

Rachel: Mm-Hmm. I love that. I actually recently did an episode where I talked about my need for. empathy first with my husband. I was talking to a marriage therapist and I told her that I have encouraged my husband empathy before questions or answers, please. I just need a little validation before we jump to fixing it, and that is so true for our kids as well. Validate even if the feeling is irrational before you try to dismiss it, brush it away, solve it for them. I have a daughter that is a little bit resistant to validation of her emotions, and sometimes it’s different than my son.

My son has always responded really well to me, saying like, I know what [00:03:00] that feels like, or That be really hard. Whereas my daughter is more don’t talk, don’t like she’s annoyed by that. When I validate her. She came out of school recently and told me that she had a really bad day and trying to be a good mom and not jumping to fixing it or asking why. said, I sometimes have days like that too. And she said, “Oh, that’s so mean, mom. You didn’t even ask me what happened. Now I’m not gonna tell you.” I was like, okay, different kids need different strategies. So what do you do if you have a kid that kind of resists you validating their feelings? Ya.

Dr. Terri Bacow: So let me echo what you just said: different kids require different approaches. You need to know your kid, and it’s okay to test different things out, to see what they respond to. And the example you just gave, , I think that was so lovely. One little bit of feedback, , to not make it about us or about you. So when you say, “Oh, I know what that’s like,” they may feel that it’s about you. So you want to just change your phrasing and say, “That sounds awful. Tell me more about that.” So that the attention is and focus on them. But if she still, if it still doesn’t resonate, just roll with it. Don’t react and just move on.

Rachel: Just move on. And I love what you said about you have to try different things for a while to find what works for your specific kid and you’ll have lots of opportunities to try again. So if you try this validation and it’s a fail. It’s just sort of like information for you. Oh, she really didn’t like it that way. Like, but luckily in about 30 minutes she’ll probably have another big emotion and I can try validating in a different way. So it’s just like an ongoing investigation of our kids and figuring out what works for them. Going back to what I mentioned at the beginning of the interview, how do you know when anxious feelings in your kids are just [00:05:00] normal versus when they’re starting to be something that you need to seek more support about.

Dr. Terri Bacow: Excellent question because anxiety could be a normal part of development. I think all kids have fears, many of them have phobias, many of them have worries. So the point at which I think as parents we might be a little bit concerned is when the anxiety really seems out of proportional or it’s frequent, it’s intense, you see behavioral changes, you see shift in mood and you see impairment in functioning. When the anxiety kind of starts to interfere in your child’s life or even in your life. So if you have a kid, for example, that’s coming out of the room multiple times a night and you’re not getting any sleep, they’re not either. So that is an impairment in functioning. That is a good moment to kind of investigate help.

Rachel: Hmm. Yeah. I do feel like, and correct me if I’m wrong, because you’re the expert in this, that there are certain ages when all kids show a little bit more anxiety because developmentally they’re starting to become more aware of their world. And I feel like that’s kind of where my daughter is right now. She’s nine, she’ll be 10 this summer, and I think she’s just starting to realize that the world is a lot bigger than she is. That things can happen to loved ones, like loved ones can pass away or get hurt. Like it’s, as our kids grow up, they start to realize that the world is a difficult place.

And of course that’s normal to feel some anxiety around that, but I feel like as parents it can be really difficult and triggering when our kids start to voice some of that and we can worry for them. My daughter recently was crying at bedtime and said, “When you die, I’ll never be able to talk to you again.” And that just seemed like, whoa, that is like a dark thought a, for a little one. But also my mother passed away when I was a teenager. My kids know that. So I think she has context to start thinking about what that was like for me. She’s starting to feel more empathy for other people and she’s realizing that would be really hard to go through that.

But for me, as somebody who’s had anxiety, I immediately like go to, oh my gosh, she’s inherited my anxiety. I need to get her help. Like these are really dark thoughts for her to be having, and I sort of catastrophize it versus just taking a step back and saying, I think this is part of the normal feelings of growing up.

What are your thoughts that when you hear that story and just about growing up in general?

Dr. Terri Bacow: Yes. So in that story. I think as a parent, I would’ve reacted to that as well. So let me just say you’re not alone. That is an upsetting. We don’t want our kid to be uncomfortable, so I think we react quickly. So as a good parent, we need to tolerate our children’s discomfort. It is okay for them from time to time to have a thought or a feeling that’s negative. It’s not always a cause for alarm. I would be concerned if, let’s say she was saying that day after day. If she brings it up one time, then it’s a good opening to have a real dialogue maybe about that and dying and feelings, and then maybe that’s all she needs. But if let’s say this is something that’s coming up day after day, and she’s really preoccupied that she’s distracted, then I might be a little bit more concerned.

Rachel: Hmm. Yeah. What would you say? ‘Cause I didn’t know what to say. What would you say if your child said, “When you die, I’ll never be able to talk to you again.”? How, how does a parent respond to that?

Dr. Terri Bacow: Yes. Okay. That’s a big one, but I think that we need to, like I said, going back to takeaway number one, validate, right? So the first thing to say is “That’s really scary to think about. It will be sad when we can’t talk to each other anymore. , however, that’s not going to happen for such, such, such a long time and this is not something to worry about in this moment. This is, concern for later. I will go with to have so many fun time together before we even need to think about that.

Rachel: Hmm.

Dr. Terri Bacow: So, kind of reassure them as well as logic. I think it’s good to infuse logic and reframing, which is a technique from Cognitive Behavioral Therapy or CBT, which is what I do.

Rachel: Mm-Hmm. And I do think having a few scripts, or not even scripts, but sort of templates to use when your kids say something upsetting is helpful for parents. So whether it’s your kids saying something about death, or it’s your kids saying something like, “Nobody at school likes me,” and you want to immediately go to like, oh, that’s not true. You know, because you, you wanna fix it, you wanna help them feel better. Do you have any scripts or templates for like, parents who just, so maybe if they, if their kid says something to them this week, they can pull it out use it to validate the emotion before fixing it.

Dr. Terri Bacow: Ya. So before I go into the script, I want to share my second takeaway, which is we need to have a poker face. We need to model that we have it together, even if we don’t feel the way. And it’s not that you can’t as parents display emotion, but you also don’t want to scare your children by making a really, really big deal and giving the anxiety all this attention. And so you wanna stay calm. Poker face.. And then, , again, you want to validate, you know, “It’s normal to feel this way. Everyone feel this way from time to time. It’s awful to feel that no one likes you. Do you have any evidence or proof that nobody likes you?” This is where the challenge comes in. The kind of, not just jump to, “Oh, that’s ridiculous!” Because never, and there has to be of being told to calm down has someone just calm down. So I think it’s helpful to challenge a little bit and explore where is this coming from? Did something happen? And then to try to problem solve with them around that maybe one kid was mean to them, and then they feel that nobody likes them. So in that instant, maybe try to kind of come up with a plan for how they’re gonna manage that situation and to ask them, “What do you think about this plan?” Because you want it to be collaborative. You want to work with your child and collaborate on a plan. And the last piece is you could also throw in the fact that people don’t always have to like us, that it’s okay if somebody does not like us because we cannot please everyone, every moment of every day.

Rachel: Mm-Hmm. Isn’t that the truth? Yes. And I think you, what you spoke to of having our own poker face is so important, and I know in reading through your outline, you talked about modeling. Calm, brave behavior for your child, even with your own anxieties and your own phobias. So not only in reaction to theirs, but also with your own. And you mentioned that you have a bug phobia. Can you tell us a little bit about that and how you manage that around your children?

Dr. Terri Bacow: Yes, yes. So when I say bug phobia, this includes lady bugs and butterflies. All bugs. All bugs. Yeah. So if I see a bee, I would be tempted to scream and run away, and I’ve done that, and then my kids will also scream and run away. And so my husband blames me because they’re now afraid of bugs. So I have learned to hold it together and to just pretend to be okay with it. I think you had mentioned when we kind of conferred earlier that it could be helpful to talk through how we’re coping, you know, to say, ” This scares me, but I’m gonna be really brave, brave, I’m going to do some breathing. I’m, I’m going to stay in this situation even though it’s hard.” I think it’s good to model that for our kids.

Rachel: Yeah, and to talk it out for them. So often I think we’re doing our own self-coaching, but we’re not narrating for our kids kind of what we’re doing, and that narrating is an important step to showing them that everybody has fears, and these are the tools we’re using to face them. So saying like, “This bug really creeping me out right here, but I know it’s safe. I know it’s not gonna hurt me, and I’m taking deep breaths.” And so they kind of know what you’re doing to manage it. I try to involve my kids in a lot of what’s going on in my work. I’ll let them know if I’m teaching an online class nervous about it or intimidated and it’s really special that they encourage me.

And they, will say, “You can do it, mom.” You know, and then afterwards I’ll say, “I did it. I was so nervous, but I did it and I’m so glad I pushed through the fear because that was such a good experience.” And then they can celebrate with me. So really narrating our lives talking to our kids about our emotions can make it easier for them to manage their own.

Dr. Terri Bacow: Absolutely. I think it’s good for kids to know that we’re human and we make mistakes, and that it’s also a common aspect of CBT, that other people could be so much more objective, right? So if someone comes to you. with a worry, you could tell them it’s going to be okay, but when it comes to you, you’re entirely freaked out. So I think it’s so lovely that your kids were able to reassure you. I think you were able to model for them how it’s okay to have negative emotion, and that it’s also okay to comfort them.

Rachel: Mm-Hmm. Yes. And I think this leads well into your third takeaway, which is really a question about, , , how often do we push our kids? You know, how often do we push them to get through this anxiety? So what is your third takeaway for us?

Dr. Terri Bacow: My third takeaway is to not enable with, or collude with, avoidance. Anxiety and avoidance are best friends. We need to break up that relationship. What I mean by that is our kids might frequently be, when they’re anxious, try to escape or avoid a situation. That’s entirely understandable. They will say, “I don’t want to go to school today,” Or, the sleepover. “Please come pick me up.” And so my advice really is to try to not let them escape. To try to encourage them to stay in this situation and not leave essentially, or to go and do the scary thing. And one of my other pieces of advice is we can buddy with them. We could do it with them. We could suggest small incremental steps. You know, maybe you could do part of it. Not the whole thing. Can you stay at the sleepover for just one more hour? You can do it. Because if they avoid, what it ends up doing, it’s just reinforcing or solidifying the anxiety and teaching them they can’t do it, rather than they can. That is not gonna be so bad.

Rachel: Mm-Hmm. Yeah, I have heard. I have heard that when you avoid something that you are afraid of, the fear grows. and that, that’s sort of the concept I think, behind exposure therapy, that you start to slowly expose them to the thing that they’re afraid of in manageable, small doses, and then you increase it. But I, I didn’t know if that was backed by research or if that was just something that I had heard. So you’re saying that it is true that the more you avoid something, the the scarier it will become to you?

Dr. Terri Bacow: Absolutely. The reason this is, is that when we avoid our anxiety drops temporarily, but that the next time we do it, it peaks higher. Because we have the memory of how good that escape felt, and it removed the learning opportunity. And you’re absolutely right, exposure therapy is one of the most, , evidence-based techniques that we have to treat anxiety and phobias for that reason.

Rachel: Hmm.

Dr. Terri Bacow: Because exposing yourself will lead to habituation, which brings the anxiety down. If you can tolerate the spike, the peak, then it will become lower and lower the more you do it.

Rachel: Yeah, so I have often wondered with my own anxieties and my own anxious daughter I also want to teach her to trust herself, and to trust her body, and to listen to her intuition, and to not be a people pleaser who just ignores herself to make other people happy. And so I’ve sort of had to walk this line between, I want… So for example, , the children at church always do a primary program once a year, and my daughter , is terrified of public speaking. And so all of the children stand up and say a little line. And for most of her life I have said, “You don’t have to do that.” You know, like, “It’s okay that you don’t wanna be a public speaker.” And it’s been a little uncomfortable for me because I feel like sometimes the church leaders kind of judge me because I don’t make her do it.

But I’m also like, she’s five years old. Like if she doesn’t wanna stand up and say the sentence, I have encouraged her to be up there on the stand and sing with other children in the group. But if she doesn’t wanna come up and say her part, I sort of advocate for her and say she doesn’t have to do that.

She’s really young. It’s okay. , But then I’ve wondered, am I enabling that behavior by not forcing her to do the thing that the adults in her life want her to do, but that feels really scary to her. So what are your thoughts on that?

Dr. Terri Bacow: My thoughts are, there is a caveat, which is that it is a judgment call. As the parent, we get to decide, you know, you know your child really well and you know what they’re capable of. So there are definitely exceptions. And I always say there is a fine line between avoidance and self-care. So we need to make that judgment. We need to decide is this avoidant or is this not appropriate? Is this demand too large of a demand for them? that’s a judgment call. And it could be a little tricky to kind of figure out. Is this avoidant [00:20:00] or this self care? But I think as parent, we need to trust ourselves that we know the difference.

Rachel: Mm-Hmm.

Dr. Terri Bacow: In the example you gave, at five, I wouldn’t push. Maybe at six or seven.

Rachel: Right. Yeah, and I mean, as a success story. I never pushed her to do it. And then last year she decided to do it when she was eight. And so it was almost like she needed to be ready for that, you know?

But then another example of where I did push her is, , she was recently invited by her teacher to do a piano festival. It’s her first time ever doing that, and she does have a fear of being in front of people and performing. And so her initial reaction was: I’m not doing that. Not in front of her teacher because of course she holds it together in front of her teacher, but when she got home there was screaming and crying and “I’m not gonna do it. I don’t wanna do it.” And so I took a deep breath and I said, [00:21:00] “Well, let’s find out more information first. ‘Cause I was trying to decide do I push her or do I let her off the hook on this one? And so I talked to the teacher and found out, I said, “So, what, what exactly is gonna happen that day?” The teacher talked. So I think that’s important for kids that they know step by step. So the teacher talked her through and said, “You’ll come, you’ll go into a room with one judge. You won’t be in front of a big audience. The judge is another piano teacher. She’s my friend. She’s very nice. And you’ll play your two pieces and then you’ll leave.

So she walked her all through it. And after hearing how it was gonna go, I thought “she can do this.” If, if the piano teacher had said, “Oh, you’re gonna be up there in front of a hundred people.” I may have let her opt out, but one person pushing her to overcome the fear. And what’s interesting is that when I told her, “This is good for you. You’re gonna do it.”

And I had resolve, she stopped fighting so much. I think when she could tell that I was kind of waffling, she was more like, “I don’t wanna do it” but once I said, “We’re doing this, and I will support you, and I will help you prepare.” She kind of stopped fighting it. I said, “After the festival,we will get you your favorite treat so you have something to look forward to.” And the festival just happened last Saturday and it was the cutest thing, Terri. She was so nervous. She went in, she played her pieces. I was waiting out in the hall her teacher and a few of other parents that were there for their kids and at, I her pieces are like a minute long. So literally after three minutes, very short time, she comes busting out of the room. She threw the door open and said, “I survived.”

We all burst out laughing. All the adults in the hall burst out laughing and I gave her a huge hug and I said, “You did it. You did the hard thing.” And so she’s building up that muscle and maybe eventually she will be able to play in front of a hundred people.But we had, I had to push her a starting place to start to overcome that anxiety.

Dr. Terri Bacow: A hundred percent. There’s so many takeaways within that story. You modeled, you know, you had the resolve, you built resilience. You encouraged her to be brave. You found that information, which I think that’s a great point. It’s really important. You made a judgment call and you incentivized. I also wanted to throw in there that incentive can be good. You know, if they’re proportional. And it can be good to incentivize great behavior, “Let’s get a treat afterwards.” That was outstanding, I just love this story. You did and said all of the right things, and I really did think it illustrates so many of the points we’re talking about today.

Rachel: Oh, well, thank you. Good. I’m glad. I’m, I’m trying. So it’s good to hear professionals say that. And I do think with incentivizing it can get tricky sometimes. Like you don’t wanna be incentivizing your kids… If your kids are afraid of going to school, you don’t wanna set up, that you’re going to give them a treat or a reward every single day for going to school.

That’s like a, that’s a regular thing they’re gonna have to do in their life versus this like one-off experience of doing this hard festival or working for this hard goal. But I do have several friends who have kids with extreme , school resistance or like school phobia, and it’s a daily battle and a daily difficult thing for these kids and their parents.

What would you say if there’s a mom listening who has kid that they are facing something every single day where their kid is feeling extreme anxiety around it?

Dr. Terri Bacow: Sure. So I do think what you described in terms of school refusal, that might be an instant where we enlist professional help. I mean, it might not be possible, but if it is a possibility, that’s a perfect moment to find a CBT therapist to team up with you, to give you advice to work with your child. Great example. School refusal is a whole program, but you need to start with going to school at least part of the time. Maybe they sit in the guidance counselor’s office.They need to go, they need to go for at least part of the day. There can be an incentive. I think that situation, it will be appropriate to kind of come up with a chart every day that you go, this is a point that you’ve got. If you’ve got this number of points, you’ve got a prize. You also want to enlist the professionals at the school to team up with you or work with you, collaborate. Maybe they need to sit in this favorite teacher’s office for 30 minutes before they go in. This is where we get creative.

Rachel: Yes. Working with professionals both in the school and outside of the school to try to support these kids. I have two friends that it’s when kind of, I think when their kids went through puberty. Hormones were shifting, I’m sure friend groups, social groups were shifting. It got [00:26:00] really, so hard, and they did have to seek a lot support to get it figured out. So that’s why I’m grateful for professionals like you who do this work every day. And you have taken your work you do in your office with clients and you’ve turned it into a book that’s sort of a self-paced tool. So tell us a little bit about your book.

Dr. Terri Bacow: Sure. So this book is called Goodbye Anxiety: A Guided Journal for Overcoming Worry, based on evidence-based strategies for anxiety management. The first part is a worry dump section where kids and teens get the opportunity to write the things that are on their mind with prompts that are curated. I incorporated a lot of pop culture and songs and movies that I thought would be relatable. After this first section, there’s an entire section devoted to challenging anxious thoughts. You know, how to identify them, how to challenge them using these evidence based strategies from CBT and from other research-supported therapy.

Rachel: Well, what a gift for families that you’ve created that for the overwhelmed parent that doesn’t know where to start with supporting their kid who’s showing some signs of anxiety. This is a great place to start, is to get this journal, this workbook. And Terri, I’m so grateful that you came on today and shared your expertise with us and I feel like I got a personal therapy session for my, for myself with my children, and I’m so glad we could bring that to everyone on 3in30. So thank you for being here.

Dr. Terri Bacow: Thank you so much for having me.