Latest / Play Therapy Parenting: Real Parenting Questions Answered by a Child Therapist / S3E26 - Parent Companion for Play Therapy: Understanding Anxiety in Child-Centered Play Therapy

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S3E26 - Parent Companion for Play Therapy: Understanding Anxiety in Child-Centered Play Therapy · Play Therapy Parenting: Real Parenting Questions Answered by a Child Therapist

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  You're listening to the Play Therapy Parenting Podcast
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  with Dr. Brenna Hicks.
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  Hi,
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  I'm Dr. Brenna Hicks,
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  The Kid Counselor.
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  This is the Play Therapy Parenting Podcast
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  where I give you insight,
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  awareness,
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  and enlightenment about your parenting
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  and your relationship with your kids.
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  In today's episode,
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  we're continuing the Parent Companion series
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  and we are diving into the seven most common
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  presenting concerns and or behaviors
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  for which children
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  are part of the
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  child-centered play therapy process.
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  And I want to look at each one individually in a
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  separate episode so that I can kind of unpack a little bit
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  what it looks like in the playroom,
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  how CCPT will address these concerns,
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  and what is actually taking place while the
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  child works through some of these issues.
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  So,
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  the first one we're going to tackle is anxiety.
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  And this is something that
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  has always been,
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  I've been doing this for almost 21 years.
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  Anxiety has always been a pretty consistent reason
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  that parents seek child-centered play therapy.
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  Interestingly,
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  since COVID,
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  There has been,
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  I would argue,
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  maybe a
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  500% increase,
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  1,000% increase.
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  The volume of calls for children struggling with anxiety in the last five years
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  has skyrocketed.
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  And so,
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  I think that this has become a more pervasive issue
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  and more common concern.
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  And so we're going to start with that one because it's
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  the reason why many,
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  many parents are seeking therapy.
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  So one of the things that we know about anxiety
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  in children.
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  is that there's often a predisposition for it
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  related to personality.
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  So,
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  let me kind of paint the picture of anxiety as a whole,
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  and then we'll dive into CCPT specific
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  addressing anxiety.
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  What we understand is that most of the time,
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  children that end up very anxious at some point in childhood,
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  they have a predisposition or a likelihood because of their personality.
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  And we can argue that some of that is genetic.
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  We can argue that some of it is just God-given personality.
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  But essentially a child is born
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  with either
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  a little bit of an anxious bent
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  or
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  a little bit of a fearless bent.
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  And so
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  it's rare,
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  if ever,
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  that a child develops
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  anxious behaviors or anxiety becomes a pressing issue
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  if there hasn't always been an undercurrent of anxiety.
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  So it's
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  actually very uncommon for a parent to say,
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  I've never seen any evidence of anxiety in my child until now.
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  It's almost always under the surface where it's managed and controlled
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  and tamped down to a degree.
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  And then something happens
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  that causes it to shoot up
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  and then it's very,
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  very difficult to get it back to that undercurrent surface level again.
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  And so we know that there's likely a long running history
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  of anxiety
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  when kids are dealing with
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  unmanageable levels of anxiety at some point.
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  We also know
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  that as children become more and more anxious,
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  they start to fear the fear.
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  So let's unpack that for a second.
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  Kids,
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  and this is true of all humans,
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  this is not unique to just children.
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  So if you have struggled with anxiety,
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  you will understand what I mean with,
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  you start to fear the fear.
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  What typically happens is
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  a very
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  natural,
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  organic,
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  random scenario takes place.
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  So,
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  child chokes on a piece of food.
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  It was a one-time thing,
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  a random experience,
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  an outlier,
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  if you will.
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  But
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  that one moment
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  is a catalyst
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  for a lot of anxiety
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  to increase after that.
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  Sometimes a child
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  goes through something pretty traumatic.
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  So they get into a car accident,
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  they
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  experience a house fire,
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  they
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  Get injured pretty significantly and end up in a cast or something like that.
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  So,
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  isolated,
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  unique moments in a child's history
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  that are just natural and random,
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  that becomes the starting point
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  for anxiety to grow.
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  And what happens is kids start to
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  say,
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  oh no,
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  what if that happens again?
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  And the oh no what if
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  becomes a running dialogue for children.
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  It's a running dialogue for adults too,
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  but
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  it's even more prominent for kids because
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  kids are not rational.
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  They're not cognitive.
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  They can't think their way through things.
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  So they're going to feel very deeply
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  and feeling
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  the fear
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  of,
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  oh no,
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  what if becomes all consuming.
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  So what we see often
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  is that kids start to try to control
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  things over which they have control
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  as an antidote to the anxiety.
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  In other words,
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  when I feel anxious,
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  I feel powerless.
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  When I feel anxious,
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  I feel out of control.
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  When I feel anxious,
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  the world is scary.
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  It's unpredictable.
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  It's not governable.
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  I hate that feeling of vulnerability.
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  So therefore I'm going to start grasping at control wherever I can.
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  So we almost always see
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  anxiety and control
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  hand in hand.
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  The fancy word for that is comorbidity.
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  So we see a lot of comorbidity in children of high levels of anxiety,
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  high need for power and control.
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  And it makes sense because whatever happened
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  to cause the anxiety,
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  the child felt powerless.
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  So I'm going to take power where I can because I don't ever want to feel that way again.
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  So that's something else we need to keep in mind.
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  And
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  now let's talk about what happens when we have a
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  child in
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  CCPT.
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  More often than not,
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  anxious kids are slow to
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  engage in the process.
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  They're slow to get into their work.
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  Their resistance is very high.
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  And this would be true for even children that are not participating in play therapy.
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  They are tentative.
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  They're hesitant.
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  They're timid.
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  They don't dive in.
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  They don't do anything quickly.
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  There's just this cautious hesitance
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  for almost everything that they do.
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  And that's true in the therapy room as well.
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  So,
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  it takes them a while to build trust with the therapist.
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  It takes them a while to get into work.
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  And in the midst of that,
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  when we go back to the phases,
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  and if you're new to the podcast,
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  first of all,
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  welcome.
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  So glad you're here.
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  And if you are listening to this maybe as your first episode,
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  and you've not listened to season 3 from the start,
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  I would encourage you to do that.
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  Obviously,
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  season 1 and season 2 are there for your listening pleasure as well.
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  But we are in an entire series for season 3.
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  And we talked about the stages and phases
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  and how the child will work through things in,
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  in order,
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  if you will.
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  So,
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  when we think about them moving through those phases,
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  we know resistance is one of the four.
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  And anxious kids' resistance is huge,
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  and I'm sure if you have an anxious child in therapy or not,
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  you have seen
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  huge levels of resistance.
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  Absolute refusal.
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  Meltdowns,
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  tantrums.
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  I'm digging my heels in the sand,
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  and you will not budge me.
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  And it's seen as defiance,
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  and it's seen as disobedience,
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  and it's seen as rebellion and all of these things.
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  None of those are actually at the root of what's going on.
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  They're scared to death,
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  and they're grasping at control.
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  So we have to understand that that is a
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  normal part of the process in child-centered play therapy.
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  Everything is a little bit slower.
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  Now,
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  once they get into the work phase,
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  they start tackling stuff and they're rolling and they
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  get in their groove and they find their rhythm.
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  But until then,
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  there's a slower,
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  more cautious pace,
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  and we have to honor that and understand that the child will do
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  what they need to do in their way and in their time.
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  What do we see in sessions?
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  Well,
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  almost always with an anxious child,
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  we see at some point fear facing behavior.
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  And it's not,
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  this isn't an interesting anecdote,
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  because sometimes the fear facing behavior has nothing
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  to do with the child's actual fear.
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  Sometimes it does.
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  I've had kids with debilitating
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  fear of eating
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  to where they
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  have
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  been diagnosed with failure to thrive by pediatricians.
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  They've lost weight.
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  They can no longer play sports.
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  They refuse to eat anything other than liquids.
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  I mean,
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  I,
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  my very first session with a child that I began with
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  came with an NG tube.
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  taped to the back of his neck and in place because they were
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  feeding him through his NG tube because he refused to eat anything.
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  So,
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  I mean,
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  there are times when
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  it's a really huge
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  fear
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  and it's creating crisis and it's,
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  it's scary.
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  So sometimes in that scenario,
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  kids will play out food,
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  which is actually their fear.
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  But oftentimes fear facing behavior is not
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  really related to the child's specific fear.
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  They're just facing fear in general.
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  And what happens
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  in this fear facing play
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  is kids learn that they're resilient.
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  They learn to trust themselves.
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  They learn that they can handle things.
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  They learn to problem solve.
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  They learn that they are capable and competent.
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  And that what once seemed very scary and overwhelming
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  is no longer because
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  I have faced it and I've conquered it.
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  We don't see that early on in the process,
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  but we do see it later on in the process when a child feels ready.
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  They are willing and able to face fear,
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  and
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  the playroom is a judgment-free zone.
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  Playroom is a consequence-free zone.
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  And so once the environment and the relationship are so safe for the child,
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  they feel capable
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  of actually diving in and facing some of those fears.
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  So we see that pretty consistently.
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  We also see a desensitization
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  to
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  the anxiety and the fear.
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  So what that looks like is
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  kids will play out a scenario
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  repetitively.
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  That's true across the board for all issues,
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  but specifically for anxiety,
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  a child will play out a storyline
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  or a dialogue or a scenario,
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  and what happens
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  when you do it repetitively,
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  week after week after week.
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  You desensitize yourself to the emotion,
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  to the charge,
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  to the intensity,
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  because if you can construct something again and again and again,
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  even if there's something scary in the play,
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  even if you feel vulnerable in the play,
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  even if you feel out of control in the play,
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  even if
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  the
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  environment is always unpredictable and scary,
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  you do it enough times repetitively.
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  And it becomes less overwhelming.
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  So the child is effectively desensitizing themselves
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  to what is going on
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  for their anxious issues.
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  And I think the most important connection that can be made.
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  When we think about a child pursuing CCPT
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  with anxiety as an issue.
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  As I've already mentioned.
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  We see a very strong connection,
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  positive correlation for those of you stats people.
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  Everyone's like,
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  Brenna,
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  you're the only stat person.
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  What are you talking about?
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  OK,
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  fine.
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  I'm,
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  I'm that stat nerd.
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  I,
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  I do like stats.
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  I think
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  the why matters and having data in front of you,
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  to me,
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  that's very exciting,
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  but I know that is not shared as a sentiment most of the time.
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  But positive correlation,
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  comorbidity,
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  strong connection,
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  whatever you want to say between
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  high levels of anxiety,
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  high levels of control.
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  OK,
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  we understand that.
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  So here's what happens over time in CCPT.
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  As
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  anxiety begins to reduce,
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  so does the need for power and control.
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  As the need for power and control reduces,
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  so does the anxiety.
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  So those are kind of parallel tracks that we often observe.
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  children
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  work on reducing anxiety and work on reducing their need for power and control.
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  And then on the flip side of that,
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  we see an increase in two things.
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  We see an increase in self-esteem.
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  Very consistently,
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  highly anxious kids
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  really do not have a sense of who they are.
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  So not only are they constantly decreasing anxiety,
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  they are constantly increasing self-esteem.
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  Why?
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  Because if you trust yourself,
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  if you like yourself,
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  if you know yourself,
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  if you believe in yourself,
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  if you accept yourself,
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  and I can go on and on.
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  When a child feels better about him or herself and feels more capable and confident.
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  You will naturally feel like you can handle anxious situations more effectively.
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  So those are very
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  tied.
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  We have decrease in anxiety,
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  increase in self-esteem.
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  And we also have an increase in emotional vocabulary.
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  Kids who are highly anxious
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  almost always struggle with recognizing their emotions,
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  identifying them,
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  and communicating them.
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  That's why they become anxious because they feel these big feelings
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  and they have no idea what to make of them nor what to do with them.
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  So as they build an emotional vocabulary,
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  and that increases,
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  now all of a sudden
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  they start to go,
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  oh,
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  OK,
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  I'm nervous.
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  I recognize it.
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  I identified it accurately and now I can make my needs known.
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  Hey mom,
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  I'm nervous right now.
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  I don't want to go meet that new person.
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  Well,
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  if you communicate your feelings,
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  someone can address your need.
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  Someone can sit in the pocket of that feeling with you.
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  Anxiety is a silent internal.
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  Swirl
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  When
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  people experiencing anxiety share that anxiety with others,
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  if they talk about it,
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  if they make it known,
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  if they process it out loud,
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  it doesn't have the power.
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  The anxiety monster is diminished
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  when you actually discuss it
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  and openly process it.
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  What
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  is the most devastating outcome of anxiety
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  is it's almost always an internal working
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  that's spinning around in your brain.
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  Oh no,
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  what if?
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  I don't want that to happen.
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  I can't handle that.
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  No,
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  I'm not going to let that happen.
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  I'm going to do this instead.
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  There's this real fast paced dialogue
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  that is a swirl of fear.
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  But no one knows that you're dealing with it because you're just quiet.
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  And so as kids develop an emotional vocabulary,
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  now all of a sudden they're able to communicate their needs,
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  have them met,
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  process things out loud.
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  It takes away the power
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  that anxiety once had over them.
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  So that's kind of a big picture overview
• 15:15
  of anxious
• 15:16
  kids
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  and anxiety as the root of why children are in CCPT
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  and how it unpacks itself in the playroom.
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  Hope that that gives you
• 15:27
  a new perspective on your child's anxiety.
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  And even if your child is not in
• 15:31
  play therapy and or you're not pursuing it.
• 15:34
  My hope is that if your one of your kids is anxious,
• 15:38
  this will give you some insight into how to help them,
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  how to understand what's going on for them.
• 15:43
  And you can relate to them differently as a result,
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  because as we all know,
• 15:48
  and we say over and over again,
• 15:49
  it always comes back to relationship.
• 15:52
  So we want to meet our kids where they are.
• 15:54
  We want to become a student of our children.
• 15:57
  Learn what makes them tick.
• 15:59
  Learn what makes them scared.
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  Learn what makes them upset.
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  Learn how they handle things.
• 16:03
  What's their predisposition?
• 16:05
  Are they going to externalize or internalize?
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  Are they going to
• 16:09
  withdraw?
• 16:10
  Are they going to pursue?
• 16:11
  Are they,
• 16:12
  how do your kids respond if one of your children
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  responds with anxiety?
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  You need to learn how to meet them where they are and help them through that,
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  even if you are not partnering with a child-centered play therapist.
• 16:26
  So,
• 16:26
  I hope that was encouraging and helpful.
• 16:28
  If you would like me to answer one of your questions,
• 16:30
  I would love to hear from you,
• 16:31
  Brenna at the kidcounselor.com.
• 16:34
  And it is my hope that every week that we hang out together,
• 16:37
  that you are reminded of how incredible your kids are
• 16:41
  and how they are worth pouring into
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  and the relationship is the most important component
• 16:47
  of being a parent.
• 16:48
  I love y'all.
• 16:48
  We'll talk again soon.
• 16:49
  Bye.
• 16:50
  Thank you for listening to
• 16:51
  the Play Therapy Parenting Podcast with Dr. Brenna Hicks.
• 16:55
  For more episodes and just subscribe to our newsletter,
• 16:59
  please go to www.playtherapyparenting.com.