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如果孩子容易焦慮,家長們應(yīng)該記住這六件事

KORIN MILLER
2024-04-16

有八分之一兒童受到兒童焦慮障礙影響。

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有八分之一兒童受到兒童焦慮障礙影響,這成為困擾許多家庭的難題。然而,盡管兒童焦慮障礙較為普遍,卻鮮有人討論這個問題,因此面對焦慮的孩子,許多家長會措手不及,甚至感到無助。

美國全國兒童醫(yī)院(Nationwide Children’s Hospital)兒科心理學(xué)家塔納·斯奈德心理學(xué)博士表示:“患有焦慮障礙的兒童通常依賴性強,很難獨立完成任務(wù),而且可能脾氣暴躁。這可能影響整個家庭。”斯奈德表示,家長既要給孩子設(shè)定限制,又要認(rèn)可孩子的情緒,這很有挑戰(zhàn)性。

但心理學(xué)家們表示,他們經(jīng)常幫助有焦慮障礙的兒童,其中部分治療方法是教會家庭如何應(yīng)對相關(guān)癥狀。雖然沒有心理學(xué)家會認(rèn)為養(yǎng)育有焦慮障礙的孩子是小菜一碟,但他們發(fā)現(xiàn)有一些工具可以幫助他們的生活變得更加順利。他們建議焦慮障礙兒童的家長要牢記以下幾點。

焦慮表面看起來像是行為問題

發(fā)脾氣在所有一定年齡段的孩子中都很常見,但它也可能是兒童焦慮障礙的外在表現(xiàn)。紐約大學(xué)蘭貢健康(NYU Langone Health)臨床助理教授、心理學(xué)家和《Mind in View》播客的主持人之一西婭·加拉格爾表示:“焦慮可能表現(xiàn)為因為某件事大喊大叫,或者與你爭吵。有時候可能很難分清這是正常的兒童行為,還是因為某些更嚴(yán)重或更深層次的問題導(dǎo)致的行為。”

斯奈德表示,對于這些發(fā)脾氣的情況,“焦慮癥兒童可能很難控制,但設(shè)定限制和邊界依舊很重要。”也就是說,你不能把孩子發(fā)脾氣歸咎于焦慮,并假定自己對此無能為力。斯奈德建議,在孩子平靜下來之后,提醒他們你的規(guī)則和預(yù)期,并告訴他們?nèi)绻蛔袷匾?guī)則可能要面臨的后果。她說到:“你依舊需要基于事實規(guī)定紀(jì)律和強調(diào)后果。”

承認(rèn)孩子的感受很重要

費城兒童醫(yī)院(Children’s Hospital of Philadelphia)兒童與青少年精神疾病和行為科學(xué)科焦慮行為診所的許可心理學(xué)家伊莎貝拉·米蘭尼亞克博士表示,當(dāng)孩子生氣時,認(rèn)可孩子的情緒很重要。她建議家長要有“成長同理性”,即家長不會忽視在孩子的年齡很嚴(yán)重的煩惱。她表示:“成年人可能覺得孩子的煩惱很幼稚,但它可能與孩子的世界是成正比的。不要說‘沒什么大不了的’或者‘不需要擔(dān)心’這種話。”相反,米蘭尼亞克表示,重要的是讓孩子知道你理解他們的煩惱。

她建議家長這樣說:“我知道上學(xué)前的早晨,對你來說很難。我能看得出來你有些害怕,寧愿呆在家里。我能理解:有時候我也會因為緊張寧愿呆在家里,也不愿意去工作。”

加拉格爾強調(diào)“感受始終是真實的”,即使你不能理解為什么孩子會在某個時刻產(chǎn)生這些感受。她說到:“我們總是可以承認(rèn)焦慮的感覺是多么糟糕。”加拉格爾建議跟孩子聊一聊“反擊焦慮”,強調(diào)他們可以掌控自己的情緒,不讓焦慮控制自己。

保持平靜是關(guān)鍵

安蒙表示,對孩子保持冷靜很重要。她承認(rèn):“有時候,當(dāng)孩子悲傷、尖叫或大哭的時候,家長很難保持冷靜。”加拉格爾也表示認(rèn)同,但她強調(diào)了保持冷靜的重要性。她說道:“盡量保持冷靜。”

她指出,情緒可能具有傳染性。她表示:“如果你處于危機狀況,而其他人開始驚慌失措,你的應(yīng)激反應(yīng)可能也會受到影響。”如果你發(fā)現(xiàn)當(dāng)孩子情緒激動時你很難保持冷靜,她建議咨詢治療師,獲取可以使用的工具或者自己接受治療。她說道:“當(dāng)孩子情緒激動時,家長最好的做法是盡量保持冷靜,重申他們的選項,并談?wù)撍麄兛梢宰龀龅倪x擇。”

對于孩子的焦慮有時候要順勢而行

斯奈德表示,孩子的焦慮情緒可能很難阻止,尤其是當(dāng)孩子情緒激動時。她表示:“如果孩子的焦慮情緒達(dá)到了最高點,有時候我們需要順勢而為。如果孩子已經(jīng)極度焦慮,你可能無法帶來任何有效的改變。”

加拉格爾表示,這意味著你只需要陪著孩子,給他們一個擁抱,給他們獨處的空間,直到他們自己平靜下來。斯奈德說道:“如果孩子發(fā)脾氣或者感到焦慮,我們應(yīng)該為他們提供一個安全的空間,讓他們表達(dá)這些感受。”這時候可以幫助他們實踐在治療過程中學(xué)會的技能,例如一起深呼吸五次,倒數(shù)三個數(shù),或者醫(yī)療保健提供者可能分享的其他技巧。斯奈德表示:“這樣可以轉(zhuǎn)移他們的注意力,讓他們身體放松,讓大腦平靜下來。”

不要徹底避免可能讓孩子產(chǎn)生焦慮的事情

如果有些事情會讓孩子感到緊張,家長可能想要幫助他們避開這些事情,這是可以理解的。但專家們認(rèn)為,這可能讓事情變得更糟糕。米蘭尼亞克表示:“隨著時間的推移,導(dǎo)致焦慮癥張加劇的主要機制是逃避,即孩子逃避焦慮、尷尬、不確定性、痛苦或其他負(fù)面感覺。隨著焦慮障礙的發(fā)展,兒童會反復(fù)出現(xiàn)逃避行為,例如上課不舉手、不上學(xué)和不發(fā)言等。”

但焦慮與女性情緒健康中心(Center For Anxiety & Women’s Emotional Wellness)的臨床心理學(xué)家希拉里·安蒙博士認(rèn)為,反復(fù)逃避某種狀況會讓焦慮癥變得更嚴(yán)重。她說到:“你可能本能地想要保護(hù)孩子,允許他們逃避讓他們感到恐懼或焦慮的情況。很可惜,這個決定有時候會加劇孩子的恐懼情緒。”

相反,米蘭尼亞克建議家長對于焦慮的孩子,要“富有同情心地培養(yǎng)勇敢的技能”。這意味著重復(fù)對他們的期望,告訴他們:“我知道這對你來說很難,但上學(xué)是你的責(zé)任,就像上班是我的責(zé)任一樣。我們怎么做才能讓今天上學(xué)變得更容易?” 米蘭尼亞克表示,重要的是立場堅定,即使孩子開始變得更加激動。她說道:“保持冷靜,并以穩(wěn)定的語氣重復(fù)你的話,讓孩子知道你沒有被孩子的情緒嚇到。”你可以告訴孩子“你因為害怕產(chǎn)生了一種激烈的情緒反應(yīng)。我并不害怕這種反應(yīng)。我們可以一起解決它。情緒不會永遠(yuǎn)持續(xù)存在,你現(xiàn)在的這種情緒很快就會結(jié)束。”

米蘭尼亞克表示,如果孩子出現(xiàn)扔?xùn)|西、打人或者沖下車等行為,一定要讓他們承擔(dān)自己的行為造成的后果。她強調(diào):“情緒始終是有效的,但我們必須對自己的行為負(fù)責(zé)。”

表揚孩子好的表現(xiàn)

對于容易焦慮的孩子,家長需要應(yīng)付很多事情,但醫(yī)生認(rèn)為,當(dāng)孩子表現(xiàn)良好時,表揚很重要。加拉格爾說道:“當(dāng)孩子表現(xiàn)良好時給予表揚,不要只專注于孩子表現(xiàn)不佳的事情。”

斯奈德也認(rèn)同這種觀點。她說道:“你依舊應(yīng)該像一般父母一樣,讓孩子知道你為他們感到驕傲。”開放式的問題也很有幫助,例如在吃晚飯或在車上的時候,讓孩子分享自己當(dāng)天最開心和最糟糕的部分。她說道:“如果孩子有不好的遭遇,這樣做可以創(chuàng)造機會,讓孩子與你溝通,分享情緒。”

總之,斯奈德建議時刻提醒自己你正在竭盡全力。她說道:“如果孩子容易焦慮,家長可能會感到壓力、沮喪和不知所措。但重要的是提醒自己,盡管目前事情可能并不順利,但你依舊是一個好的家長和監(jiān)護(hù)人。”(財富中文網(wǎng))

翻譯:劉進(jìn)龍

審校:汪皓

有八分之一兒童受到兒童焦慮障礙影響,這成為困擾許多家庭的難題。然而,盡管兒童焦慮障礙較為普遍,卻鮮有人討論這個問題,因此面對焦慮的孩子,許多家長會措手不及,甚至感到無助。

美國全國兒童醫(yī)院(Nationwide Children’s Hospital)兒科心理學(xué)家塔納·斯奈德心理學(xué)博士表示:“患有焦慮障礙的兒童通常依賴性強,很難獨立完成任務(wù),而且可能脾氣暴躁。這可能影響整個家庭。”斯奈德表示,家長既要給孩子設(shè)定限制,又要認(rèn)可孩子的情緒,這很有挑戰(zhàn)性。

但心理學(xué)家們表示,他們經(jīng)常幫助有焦慮障礙的兒童,其中部分治療方法是教會家庭如何應(yīng)對相關(guān)癥狀。雖然沒有心理學(xué)家會認(rèn)為養(yǎng)育有焦慮障礙的孩子是小菜一碟,但他們發(fā)現(xiàn)有一些工具可以幫助他們的生活變得更加順利。他們建議焦慮障礙兒童的家長要牢記以下幾點。

焦慮表面看起來像是行為問題

發(fā)脾氣在所有一定年齡段的孩子中都很常見,但它也可能是兒童焦慮障礙的外在表現(xiàn)。紐約大學(xué)蘭貢健康(NYU Langone Health)臨床助理教授、心理學(xué)家和《Mind in View》播客的主持人之一西婭·加拉格爾表示:“焦慮可能表現(xiàn)為因為某件事大喊大叫,或者與你爭吵。有時候可能很難分清這是正常的兒童行為,還是因為某些更嚴(yán)重或更深層次的問題導(dǎo)致的行為。”

斯奈德表示,對于這些發(fā)脾氣的情況,“焦慮癥兒童可能很難控制,但設(shè)定限制和邊界依舊很重要。”也就是說,你不能把孩子發(fā)脾氣歸咎于焦慮,并假定自己對此無能為力。斯奈德建議,在孩子平靜下來之后,提醒他們你的規(guī)則和預(yù)期,并告訴他們?nèi)绻蛔袷匾?guī)則可能要面臨的后果。她說到:“你依舊需要基于事實規(guī)定紀(jì)律和強調(diào)后果。”

承認(rèn)孩子的感受很重要

費城兒童醫(yī)院(Children’s Hospital of Philadelphia)兒童與青少年精神疾病和行為科學(xué)科焦慮行為診所的許可心理學(xué)家伊莎貝拉·米蘭尼亞克博士表示,當(dāng)孩子生氣時,認(rèn)可孩子的情緒很重要。她建議家長要有“成長同理性”,即家長不會忽視在孩子的年齡很嚴(yán)重的煩惱。她表示:“成年人可能覺得孩子的煩惱很幼稚,但它可能與孩子的世界是成正比的。不要說‘沒什么大不了的’或者‘不需要擔(dān)心’這種話。”相反,米蘭尼亞克表示,重要的是讓孩子知道你理解他們的煩惱。

她建議家長這樣說:“我知道上學(xué)前的早晨,對你來說很難。我能看得出來你有些害怕,寧愿呆在家里。我能理解:有時候我也會因為緊張寧愿呆在家里,也不愿意去工作。”

加拉格爾強調(diào)“感受始終是真實的”,即使你不能理解為什么孩子會在某個時刻產(chǎn)生這些感受。她說到:“我們總是可以承認(rèn)焦慮的感覺是多么糟糕。”加拉格爾建議跟孩子聊一聊“反擊焦慮”,強調(diào)他們可以掌控自己的情緒,不讓焦慮控制自己。

保持平靜是關(guān)鍵

安蒙表示,對孩子保持冷靜很重要。她承認(rèn):“有時候,當(dāng)孩子悲傷、尖叫或大哭的時候,家長很難保持冷靜。”加拉格爾也表示認(rèn)同,但她強調(diào)了保持冷靜的重要性。她說道:“盡量保持冷靜。”

她指出,情緒可能具有傳染性。她表示:“如果你處于危機狀況,而其他人開始驚慌失措,你的應(yīng)激反應(yīng)可能也會受到影響。”如果你發(fā)現(xiàn)當(dāng)孩子情緒激動時你很難保持冷靜,她建議咨詢治療師,獲取可以使用的工具或者自己接受治療。她說道:“當(dāng)孩子情緒激動時,家長最好的做法是盡量保持冷靜,重申他們的選項,并談?wù)撍麄兛梢宰龀龅倪x擇。”

對于孩子的焦慮有時候要順勢而行

斯奈德表示,孩子的焦慮情緒可能很難阻止,尤其是當(dāng)孩子情緒激動時。她表示:“如果孩子的焦慮情緒達(dá)到了最高點,有時候我們需要順勢而為。如果孩子已經(jīng)極度焦慮,你可能無法帶來任何有效的改變。”

加拉格爾表示,這意味著你只需要陪著孩子,給他們一個擁抱,給他們獨處的空間,直到他們自己平靜下來。斯奈德說道:“如果孩子發(fā)脾氣或者感到焦慮,我們應(yīng)該為他們提供一個安全的空間,讓他們表達(dá)這些感受。”這時候可以幫助他們實踐在治療過程中學(xué)會的技能,例如一起深呼吸五次,倒數(shù)三個數(shù),或者醫(yī)療保健提供者可能分享的其他技巧。斯奈德表示:“這樣可以轉(zhuǎn)移他們的注意力,讓他們身體放松,讓大腦平靜下來。”

不要徹底避免可能讓孩子產(chǎn)生焦慮的事情

如果有些事情會讓孩子感到緊張,家長可能想要幫助他們避開這些事情,這是可以理解的。但專家們認(rèn)為,這可能讓事情變得更糟糕。米蘭尼亞克表示:“隨著時間的推移,導(dǎo)致焦慮癥張加劇的主要機制是逃避,即孩子逃避焦慮、尷尬、不確定性、痛苦或其他負(fù)面感覺。隨著焦慮障礙的發(fā)展,兒童會反復(fù)出現(xiàn)逃避行為,例如上課不舉手、不上學(xué)和不發(fā)言等。”

但焦慮與女性情緒健康中心(Center For Anxiety & Women’s Emotional Wellness)的臨床心理學(xué)家希拉里·安蒙博士認(rèn)為,反復(fù)逃避某種狀況會讓焦慮癥變得更嚴(yán)重。她說到:“你可能本能地想要保護(hù)孩子,允許他們逃避讓他們感到恐懼或焦慮的情況。很可惜,這個決定有時候會加劇孩子的恐懼情緒。”

相反,米蘭尼亞克建議家長對于焦慮的孩子,要“富有同情心地培養(yǎng)勇敢的技能”。這意味著重復(fù)對他們的期望,告訴他們:“我知道這對你來說很難,但上學(xué)是你的責(zé)任,就像上班是我的責(zé)任一樣。我們怎么做才能讓今天上學(xué)變得更容易?” 米蘭尼亞克表示,重要的是立場堅定,即使孩子開始變得更加激動。她說道:“保持冷靜,并以穩(wěn)定的語氣重復(fù)你的話,讓孩子知道你沒有被孩子的情緒嚇到。”你可以告訴孩子“你因為害怕產(chǎn)生了一種激烈的情緒反應(yīng)。我并不害怕這種反應(yīng)。我們可以一起解決它。情緒不會永遠(yuǎn)持續(xù)存在,你現(xiàn)在的這種情緒很快就會結(jié)束。”

米蘭尼亞克表示,如果孩子出現(xiàn)扔?xùn)|西、打人或者沖下車等行為,一定要讓他們承擔(dān)自己的行為造成的后果。她強調(diào):“情緒始終是有效的,但我們必須對自己的行為負(fù)責(zé)。”

表揚孩子好的表現(xiàn)

對于容易焦慮的孩子,家長需要應(yīng)付很多事情,但醫(yī)生認(rèn)為,當(dāng)孩子表現(xiàn)良好時,表揚很重要。加拉格爾說道:“當(dāng)孩子表現(xiàn)良好時給予表揚,不要只專注于孩子表現(xiàn)不佳的事情。”

斯奈德也認(rèn)同這種觀點。她說道:“你依舊應(yīng)該像一般父母一樣,讓孩子知道你為他們感到驕傲。”開放式的問題也很有幫助,例如在吃晚飯或在車上的時候,讓孩子分享自己當(dāng)天最開心和最糟糕的部分。她說道:“如果孩子有不好的遭遇,這樣做可以創(chuàng)造機會,讓孩子與你溝通,分享情緒。”

總之,斯奈德建議時刻提醒自己你正在竭盡全力。她說道:“如果孩子容易焦慮,家長可能會感到壓力、沮喪和不知所措。但重要的是提醒自己,盡管目前事情可能并不順利,但你依舊是一個好的家長和監(jiān)護(hù)人。”(財富中文網(wǎng))

翻譯:劉進(jìn)龍

審校:汪皓

Childhood anxiety disorders impact one in eight kids, making this a condition many families grapple with. But despite how common they are, anxiety disorders in kids aren’t discussed a lot, leaving plenty of parents feeling unprepared and even helpless when it comes to raising an anxious child.

“Kids with anxiety disorders can often be clingy, may have difficulty doing things independently, and can have angry outbursts,” says Tyanna Snider, PsyD, a pediatric psychologist with Nationwide Children’s Hospital. “It can impact the entire family.” Parents face the tough challenge of trying to set limits for a child while also validating their emotions, Snider says.

But psychologists say they regularly help kids with anxiety disorders, and part of that treatment is teaching families how to respond to symptoms of the condition. While none of them say that parenting a child with an anxiety disorder is easy, there are tools they’ve discovered that can make life with an anxious child a little more seamless. Here’s what they recommend all parents of kids with anxiety disorders keep in mind.

Anxiety can look like behavioral issues

Tantrums are common in all kids of a certain age, but they can also surface in children with anxiety disorders. “Anxiety can manifest as yelling or fighting you on something,” says Thea Gallagher, PsyD, a clinical assistant professor at NYU Langone Health and a cohost of the Mind in View podcast. “Sometimes it can be difficult to figure out if this is normal kid behavior or if it’s caused by something bigger or deeper.”

Those tantrums “might be really hard for the child with anxiety to control, but it’s still really important to set limits and have boundaries,” Snider says. Meaning, you don’t want to chalk a temper tantrum up to your child’s anxiety and assume you can’t do anything about it. When your child settles down, Snider recommends reminding them that you have rules and expectations, and that there are consequences when they’re not followed. “You still need to provide discipline and consequences in a matter of fact way,” she says.

It’s important to acknowledge your child’s feelings

Validating your child’s emotions is an important step when they’re upset, says Izabela Milaniak, PhD, licensed psychologist in the Anxiety Behaviors Clinic within the Department of Child and Adolescent Psychiatry and Behavioral Sciences at Children’s Hospital of Philadelphia. She recommends practicing something called “developmental empathy,” which is when you don’t dismiss worries that may feel like a big deal for your child’s age. “A child’s worry may seem silly to an adult, but it is proportional to their world,” she says. “Avoid making comments like, ‘It’s not a big deal’ or ‘You have nothing to worry about.’” Instead, Milaniak says it’s important that your child knows that you understand they’re upset.

She recommends saying something like, “I know mornings before school are rough for you. I can see that you’re scared and would rather stay home. I get that: Sometimes I want to stay home from work because I’m nervous too.”

Gallagher stresses that “feelings are always real,” even if you don’t understand why your child is having them in a particular moment. “We can always acknowledge how awful anxiety can feel,” she says. Gallagher recommends talking to your child about “bossing back the anxiety,” stressing that they can be in charge of their emotions and not let anxiety take control.

Staying calm is crucial

Ammon says it’s important to try to stay level-headed with your child. “Sometimes it can be difficult to keep your cool when your child is distressed, screaming, or crying,” she admits. Gallagher agrees, but stresses the importance of being calm. “If you can, stay as calm as possible,” she says.

Gallagher points out that moods can be contagious. “If you’re in a crisis situation and someone else starts freaking out, your fight or flight response is going to go to that, too,” she says. If you find that you’re struggling to stay calm when your child is elevated, she recommends talking to their therapist for tools you can use or considering therapy for yourself. “The best thing you can do with your child when they’re getting worked up is to be as calm as possible, reiterate their options, and talk about the choices they can make,” she says.

Sometimes you have to let them ride the wave of anxiety

Anxiety can be tough to stop, especially when a child is really worked up, Snider says. “If your child is at peak anxiety—a 10 out of 10—sometimes we need to ride that wave,” she says. “You’re probably not going to make an effective change if they’re already at that high of a level.”

That can mean just being there for your child, hugging them, or giving them space to be by themselves until they calm down, Gallagher says. “If a child is having a tantrum or anxiety attack, we want to get them to a safe space so they can express those feelings,” Snider says. This is a good time to help them practice the skills they’ve learned in therapy, like taking five deep breaths together, counting backwards by threes, or any other techniques their healthcare provider has shared. “That can distract them for a moment, relaxing their body and calming their brain,” Snider says.

Don’t completely avoid the things that cause your child’s anxiety

If something makes your child anxious, it’s understandable to want to do what you can to help them avoid it. But experts say this can actually make things worse. “The main mechanism that grows anxiety symptoms over time is avoidance, where a child escapes the experience of anxiety, embarrassment, uncertainty, distress, or other negative sensations,” Milaniak says. “By the time an anxiety disorder develops, a child has repeated patterns of avoidant behaviors, like not raising their hand in class, not attending school, and not speaking.”

But repeatedly avoiding a situation can make anxiety worse, says Hillary Ammon, PsyD, a clinical psychologist at the Center For Anxiety & Women’s Emotional Wellness. “You may have the instinct to protect them and allow them to avoid whatever is causing them to feel fear or anxiety,” she says. “Unfortunately, this decision to aid them in escaping sometimes exacerbates those fears for the child.”

Instead, Milaniak recommends that parents “compassionately foster bravery skills” with anxious kids. That means reiterating expectations by saying things like, “I know this is hard for you and going to school is one of your responsibilities, like going to work is mine. What can we do to make going into school easier today?” Milaniak says it’s important to stay firm, even if your child starts to escalate. “Remain calm and repeat a steady mantra to show that your child’s emotions don’t scare you,” she says. That can include saying something like “You’re having a big feeling response because you are scared. I am not afraid of your big feelings. We will get through it together. Emotions don’t last forever and this one will be over soon.”

If your child does things like throwing objects, hitting others, or running out of a car, it’s important to have consequences for their behavior, Milaniak says. “Emotions are always valid, but we must be accountable for what we do with them,” she stresses.

Highlight the good stuff, too

There’s a lot to manage when you have a child with anxiety, but doctors say it’s important to praise your child when they’re doing well. “Highlight it when things are going well—don’t just focus on the things that didn’t go well,” Gallagher says.

Snider agrees. “You still want to do typical parenting and let them know that you’re proud of them,” she says. Open-ended questions can be helpful, too, like asking your child to share the best and worst parts of their day when you’re eating dinner or riding in the car together. “It opens the door about communication and feelings if something is not going well,” she says.

Overall, Snider recommends reminding yourself that you’re doing your best. “Oftentimes, parents of children with anxiety are really stressed, frustrated, and unsure of what to do next,” she says. “But it’s important to remind yourself that you’re a good parent and caregiver, even if things don’t feel like they’re going well at that moment.”

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