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Coronavirus has exacerbated my six-year-old’s anxiety

It sounds like your son may have developed traits of obsessive compulsive disorder

Should I seek some type of intervention for my son’s increasing anxiety?

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John Sharry
Mon Jun 15 2020 - 06:01

Question: My six-year-old son has developed a phobia of getting sick which early this year started to inhibit his ability to go to friends’ houses and school normally. My wife and I tried various techniques such as giving reassurance, acknowledging his fears and offering empathy.

We tried buying him a “worry monster”, which is a teddy with a zip for a mouth. Basically the child puts the worry into the monster’s mouth, zips it closed and the monster takes the worry away. This teddy has given him some help and comfort, but his anxiety and fears have continued.

Sadly, the whole ordeal of coronavirus and the lockdown has really exacerbated his anxiety. He now has developed exaggerated anxieties such as fear someone has injected poison into his food. Many times during the day he looks for reassurance that he will not die or develop sickness because he, for example, touched the bottom of his sock, or picked his nose, etc.

When I was a child, albeit a few years older, I suffered with exaggerated anxiety as well as panic disorder, and I am worried that my son is heading in a similar direction. Can I ask you if, in your opinion, you believe we should seek some type of intervention for his increasing anxiety?

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Answer: It sounds like your son's fears and anxieties may have developed traits of obsessive compulsive disorder (OCD). The pattern of OCD starts with a fear or intrusive thought that becomes obsessive, which is followed by a compulsion to act in a certain way to manage. You son is dealing with a range of fears such as his food being injected with poison, vomiting or even dying. He deals with these fears by avoiding going out, constantly seeking reassurance or by rituals such as touching his sock. OCD is very hard to deal with as a parent as you easily get sucked into the obsessions and rituals yourself.

While it is important to be empathic and understanding towards your son, if you end up constantly reassuring him you can inadvertently justify his fears and even reinforce his OCD rituals. His constantly seeking reassurance from you can become one of the unhelpful compulsions to counteract his fears. Instead, the important goal in overcoming OCD is to encourage your son to learn to reassure himself and to break his compulsion to use rituals to manage his fears.

Externalise your son’s anxiety

The first step is to separate your son from his anxiety and OCD. Don’t blame him for his anxiety but instead see it as something separate that negatively impacts his life. The best way to do this is to ask your son to give his anxiety a name. This can be simply “the OCD” or more colourfully something like “the tyrant”. Then when your son is affected by a fear or obsession, you can talk about it as something external to him that you can act together to overcome. So if he says he can’t go out because he is afraid of vomiting or he is fearful that his food is poisoned, you can say, “that is just the OCD talking, don’t pay attention to it”.

Using this strategy you can encourage him to challenge this OCD thinking: “Don’t let ‘the tyrant’ stop you going out to meet your friends”; or “that is just ‘the tyrant’ talking, what can you say back, when he bothers you like that?”. Encourage him to learn to reassure and coach himself. Explain to him “tyrant” needs his attention to survive, so the more frequently he stands up and ignores it the smaller it becomes. Externalising the problem in this way can engage a young child’s imagination and motivate him to change.

Help your son change his behaviour

As well as helping your son change his thinking, you want to help him change his behaviour. Breaking this change down into small manageable steps can help. For example, if he avoids going out due to a fear of vomiting, set a small goal with him of going out for a just a short period to get started and then gradually increase.

You can help him learn to tolerate his fears by exposing him slowly to them. For vomiting, you could start by writing the word down, then talking about it, then showing a cartoon and finally a picture of it – all the while highlighting his ability to manage his fear. The key is to make the first small step easily achievable so he experiences success. In addition, you want to encourage him to reduce his compulsions and rituals in response to his fears.

Explore with him other things he can do when he is anxious, such as taking a breath or simply pausing to watch his anxiety diminish. Make a game of identifying new behaviours that might work for him. Acknowledge his bravery in facing up to his fears and then praise his efforts as he takes steps to overcome them.

Getting help

Tackling anxiety and OCD is hard work and can take time and patience. I encourage you to reach out for support and help. There are some excellent resources and books online. There is a great website (anxioustoddlers.com) that details lots of great strategies for parents of young children and also has a link to a Facebook group for families who are dealing with similar issues.

I also recommend some of the children’s books by Dawn Huebner, What to Do When You Worry Too Much (for general anxiety) and also What to Do When Your Brain Gets Stuck (for OCD), which will help your son understand he is not alone and explain clearly the strategies above as well as many others. You could also consider getting the support of a mental health professional – ask your GP for a referral to your local primary care or child mental health service.

John Sharry is a social worker, founder of the Parents Plus Charity and an adjunct professor at the University College Dublin school of psychology. See solutiontalk.ie.

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