Cara's Lessons in Anxiety Management

I have a background in Psychology and Social Work, so when Cara was born in 2006, I knew about attachment and to a lesser extent trauma and brain development. However, when I began to realise just how deeply her experiences had affected her, a desire to more fully understand this was one of the things that pushed me to learn more about these subjects. This understanding was difficult and painful initially. Like most parents, I felt guilty that my baby hadn't experienced the warm nurturing start I wanted so very much for her. However, when I was able to forgive myself for whatever it was I was supposed to have done, I was able to use the knowledge to help me understand her needs and her behaviour.

What caused Cara most distress from infancy was separation. When she was 9 months old I returned to work part time. Our work schedules meant that we needed to use daycare only one day per week, but what a day that was! As expected she became very distressed when we left her off initially. However, this continued beyond the expected 'settling in' period. In fact, it continued for most of the 3 years she was there. On many occasions I rang my husband in tears, saying I was going to leave my job. You are probably thinking that I should have found another nursery as she wasn't happy, or better still stay home with her. However, it wasn't that I didn't have confidence in the quality of the childcare. I knew the owner and trusted and respected her, the other staff and was happy with how she ran the nursery. I also knew other parents whose children attended and they were all happy. I wasn't in a financial position to pay my mortgage without my salary and had already reduced my hours as much as I could to spend as much time as possible with Cara. When she got old enough to talk about it, she was able to tell us that she liked the staff in the nursery and enjoyed it there. She didn't know why her tummy got sore and she got really upset when she went, or even when she thought about going. This visceral reaction to separation was to become a pattern for childhood anxiety.

I hadn't begun my exploration of attachment, trauma and the brain at this stage so had no idea that the reason Cara responded with such intense emotion to separation was because it triggered implicit memory related to those early days of her life. It was only when she attended playgroup and school that I began to understand what was happening. Playgroup was relatively OK. However, when she went to school things became really problematic, especially as she got older. We had lots of sore tummies, tears and clinging to me in the cloakroom. She had a deep fear that no-one would pick her up from school or that we would be killed in a car crash on our way. She was very articulate for her age, so we were able to have lots of conversations to try to get to the bottom of where these beliefs came from, but again Cara couldn't explain it. She said that, while her head knew for sure that she would always be picked up, she couldn't help how her body (in her case, her tummy and her heart) reacted. It was as if her body did not believe what her head told her.

Cara's first day at school

By this stage I knew enough to understand that her anxiety was not due to conscious thought processes, but a visceral response to an implicit memory of early abandonment. There were times when I couldn't see how we were going to get through this, especially when I was busy, stressed, tired or simply embarrassed because my daughter was screaming and clinging to me in the school cloakroom, while other children skipped into the classroom. But deep down, I knew that it wasn't the end of the world and that we could change things together.

It wasn't easy, but we did get through it together. Cara has found ways to manage her big emotions (in her case fear) and learn to calm herself. Some of the things that have helped her:

 Cara's understanding of her brain

Cara's understanding of her brain

1. Understanding her brain - I explained the brain to Cara in simple terms and she totally got it immediately. She also found Dan Siegel's analogy of 'flipping the lid' helpful. She talked about the upstairs and downstairs brain (which we later discovered is in Dan Siegel's 'Whole Brain Child' book) and how her lid flipped when she worried about not being collected from school or when she was being left off in the morning. Watching the film 'Inside Out' added to this understanding. She decided that Joy lived upstairs while Fear and the other emotions (anger, sadness and disgust) lived downstairs. She described how, when her lid flipped, the stairs moved with the upstairs floor, so Joy was not able to talk to Fear to calm it down. 

2. Knowing what to do when the lid does flip - While lid flipping incidents are few and far between these days, they do still happen occasionally. Cara went to some sessions of CBT (Cogntive Behavioural Therapy) when things were at their worst. These sessions encouraged her to reflect on her thoughts, in terms of whether they were helpful or unhelpful. Cara pointed out that focusing on thoughts when she had flipped her lid was pretty pointless. Why? Because thoughts live upstairs and this part of her brain can't be accessed when she has flipped her lid. This was a very valid point. When we are triggered and in states of anxiety or anger, we are not present in our bodies, or in the moment. We are in our heads, letting our thoughts take us on an unhelpful mental journey. Grounding techniques help us to get out of our head and back into out body. There are many such techniques, including breathing, naming what you are feeling, getting back into your body (self hug, hug from someone you love, movement, tapping) or focusing on your senses. Thankfully Cara hasn't had to use these techniques recently, but it is helpful that she has these to fall back on if she needs them. This means she doesn't get into the cycle of being afraid of the fear, which is what feeds anxiety.

3. Understanding of how her brain and body are connected - Cara understands her body more and how it is connected to her brain. She knows how she reacts to worry and stress (she gets a sore tummy and heart, faster heartbeat, clenched muscles). Therefore she can notice when things are getting little stressful and she is more likely to get triggered. At this stage both her upstairs and downstairs brain is online and she can keep herself calm by reason. Joy can still come down the stairs and talk a bit of sense into Fear, to calm down those worries.

4. Keeping the lid on as tightly as possible - Cara now understands that there are some things that help her maintain a sense of calmness and other things that don't. Nightly meditation helps a lot (this is her favourite). Technology doesn't! Like most children her age, Cara would play Minecraft and Roblox all day if she could get away with it. It is restricted to weekends in our house, but she knows that when she uses technology too much she is more likely to get anxious. She won't always admit that of course!

These are just some of the things that have been helpful for Cara in dealing with anxiety. Every child is different and anxiety manifests in different ways. However, some of the principles of how anxiety works and what keeps it under control are universal. 

I am so proud the amazing, confident, articulate and strong girl Cara has become, as she has found her way out of anxiety. She has been able to do this through awareness of how her body and brain work, along with some simple techniques. Anxiety is a huge problem for children today. If you have a child who is experiencing anxiety or work with children, I hope Cara's story has been helpful. I'll now let the lady herself tell you about her journey...