Saturday, February 20, 2016

Helping Anxious and Panicked Children

This is turning out to be a long blogpost, and I hope you'll stay with it. There is no easy answer to why the children we have in our classrooms today are more anxious than those of years past, but it's true that we see children daily who are on anti-anxiety medications.  It breaks my heart when I see medical reports for my students, and out of a group of 75-80 students, 6-10 of them have anxiety issues.

I got to experience that close-hand this week, with a boy I'll call "Q."  He's a bright 6th grader with eyes that take up a large part of his face, a great smile, and a desire to please.  He has come a long way from last year, when he had to be wrestled out of the car to enter the building.  In fact, for most of the year, his anxiety has been under control enough that it was easy to forget that this is a continuing life-struggle for him.

Working on a challenging test the other day, he told me that he thought he was going to get sick and wanted to call his mom.  I told him that calling his mom wasn't an option, but that he could listen to the Stop.Breathe,Think app to calm himself down.  This is part of the plan developed with his mom last year, and one I strongly endorse!  With an iPad and headphones, he sat and listened, and the next thing I knew, he was off and working on his test.

If you have never used this app, please try it!  Last year I had several students who listened to it before they took big tests that stressed them out. It simply uses visualization techniques to achieve calm. What I like about it is that you can choose your mood, then pick from a list of emotions, and it will tailor what you need to listen to.  It gives you choices, usually three, with varying time lengths, most from 3-15 minutes long.  I have experimented with it to better know it, and usually I'm visualizing that I'm on top of a mountain looking out, or in a sunny field; it really is quite nice!

 Several hours later, I ran into him in the hallway on his way to the cafeteria.  He was breathing heavily and about to burst into tears.  I asked him what was wrong and heard, "I'm afraid I'm going to get sick.  I need to call mommy right now!"  He was clearly panicked, so we moved over to a little alcove, plopped down on the floor, and talked. And talked.  I held him, and talked him through to a place where he could get up and come with me to a "safe" place.  He never actually ate much (I learned not to throw away his food, because he was hungry an hour later!) but he was able to rejoin his classmates for the last two periods of the day.

Here's what I learned:

1) Talk in a calm voice.  Don't be afraid to be firm, but reassure the child that he or she will be okay.  They are really holding on to your words at this point, so don't be afraid to repeat your reassurances.

2) Figure out if the child is truly sick.  Q had been in good health all morning and hadn't said or exhibited any signs of being ill.  I realized that the chances of his throwing up (his greatest fear) were slim.

3) Don't hesitate to ask the child what he/she needs.  You may not be able to provide it, but they know what helps them.  In this case, Q kept repeating that he "needed to talk to mommy."  That was a pretty clear indication to me of the level of his panic, because that's not how he would normally talk.  So I asked him what his mom would do.  He told me that she would hold him tight and talk to him in a soothing voice.  So, there on the floor, I put my arms around him and talked to him in as soothing a voice as I could.

4) Don't offer things that will put ideas in the child's head.  Q has been offered a trashcan or a bucket when he's said he's afraid of being sick.  That only makes his mind work on the idea that now another person thinks he's going to vomit.  Just stick with simple, reassuring phrases.  I don't remember everything I said, but I know, "You're going to be fine" was repeated multiple times.

5) Alert the guidance counselor, nurse, administrators, and parents when you have the opportunity.  Keep everyone in the loop so that you're all on the same page about what's being done to help this child.  Q's mom was so appreciative of the time we all took with him.

6) Recognize that although anxiety might not seem huge to you, it is to the child.  After expressing her sincere appreciation, here's what Q's mom had to say about how he feels.  It broke my heart.

I know you are all busy and having Q and his issues added to your day is not easy.  I am very sorry.  Tonight Q told me he thinks he belongs in a mental hospital, he hates his life and he wants to die.  I just ask that you please continue to be supportive of him and do your best to be understanding of his issues.  They seem crazy to those who don't have the fears that he does but his issues are scary to him.  

This was one of the most challenging experiences I've had this year.  At points I second-guessed a lot of my decisions.  Should I let him call his mom?  Would that help?  Would that only reinforce that he can't get beyond this on his own, with help from folks at school?

I don't pretend to have all the answers. But I wanted to share this experience with the hope that it'll start a dialogue among teachers, and that maybe we can share ideas that have effectively worked for us in the past.

Have you ever experienced something like this?  What have you done to help the child?

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