The No-Cry Separation Anxiety Solution: Gentle Ways to Make Good-bye Easy from Six Months to Six Years (27 page)

7

Extreme Emotions: Separation

Anxiety Disorder

Separation anxiety can be very challenging for families. There’s

no doubt it’s a diffi cult situation when your child cries, clings,

and has tantrums as you attempt to peel him off your leg. A tearful

good-bye at the door or a sorrowful face at the window can pull at any

parent’s heartstrings. However, with information, tips, and solutions,

most parents and children can work through this inevitable rite of

passage. Separation anxiety is a normal stage for most children, and

this book contains many suggestions for helping to nudge your child

through the process of managing and overcoming this stage.

While typical separation anxiety can have some intense moments,

there are children who cross the line from normal anxiety to an actual

medical problem referred to as
separation anxiety disorder (SAD)
, which

has more extreme and longer-lasting effects. This disorder requires a

Professional-Speak

“Anxiety is a vaguely defi ned and commonly used word that

also has a strict scientifi c meaning. In mental health research

the word anxiety describes the thoughts, feelings, and behav-

iors that occur when a person has the perception of serious

danger in situations where other people do not perceive dan-

ger. Anxiety means worrying that something really, really bad

might happen at any minute.”

—Elizabeth DuPont Spencer, M.S.W., Robert L. DuPont, M.D.,

and Caroline M. DuPont, M.D., authors of

The Anxiety Cure for Kids: A Guide for Parents

141

142 The No-Cry Separation Anxiety Solution

professional’s diagnosis and guidance to help your child overcome his

anxiety.

Separation Anxiety Disorder

Children with SAD may be resistant to the ideas presented in this

book. You may try for months and fi nd little or no relief for your

child’s suffering. Children with normal separation anxiety may have

some similar behaviors as those with the more extreme disorder, but

their behavior will improve over a period of a month or two when

you follow a No-Cry plan. Anytime you are concerned about your

child, of course, you should follow your instincts and talk to a profes-

sional. The following checklists can help you determine if your child

needs expert intervention on this issue and can also serve as tools

to share with your health care professional as you take steps toward

resolving your child’s separation anxiety problems.

Children who exhibit the following common signs of SAD may

benefi t from a more structured plan, plus counseling that is organized

by a professional:

• Tremendous fear of being alone

• Panic and distress that occurs when a parent leaves the room

or the house

• Crying upon separation that continues off and on until a par-

ent’s return

• Need for constant physical contact with a parent, such as

clinging, holding, and shadowing

• Clinginess that prevents normal play and socializing with

other children

• Persistent worry about getting lost and separated from a parent

• Excessive worry about a parent dying or becoming sick or hurt

• Unwarranted complaints of physical symptoms, such as stom-

achaches or headaches

• Worries and stresses about separation even before it happens

• Refusal to sleep alone after being able to sleep by himself in

the past

• Frequent nightmares about separation situations or danger

Extreme Emotions: Separation Anxiety Disorder
143

• New anxiety that develops after a life event and doesn’t dis-

sipate, such as after a hospital stay, the death of a loved one or

pet, or a move to a new home

• Persistent, intense reluctance or refusal to attend daycare or

school, or frequent excuses to stay home due to fear of separa-

tion from the home or parent

• Refusal to play at other children’s homes or attend fi eld trips,

parties, or other events (in a child over six or seven years old)

• Symptoms that persist or worsen in severity even after trying

various ideas and solutions presented in this book for a month

or more

• A parent with current anxiety disorders or who suffered from

separation anxiety disorder as a child

Key Point

Almost all children have some normal separation anxiety

between the ages of six months and six years. Separation

anxiety disorder affects approximately 4–6 percent of chil-

dren between the ages of six and eleven years, and about

1–2 percent of teenagers; it is found in boys and girls equally.

SAD very rarely persists into adulthood, and the rate of full

recovery is very high.

How Separation Anxiety Disorder Is Treated

There are a number of ways to treat SAD. The right method is dif-

ferent for each child and family situation. Here are some of the tech-

niques commonly used to treat separation anxiety disorder:

•
Play therapy.
A trained professional uses toys, puppets, games,

or art to help a child express her feelings and learn new ways of han-

dling her fears.

•
Family therapy.
The parents and therapist form a team and

create a plan to work with the child.

144 The No-Cry Separation Anxiety Solution

Kayleigh, eighteen months old

•
Cognitive behavioral therapy.
This method is used for older

children and involves one-on-one sessions with a counselor. Through

a series of sessions, the child learns how to control anxious thoughts

and behaviors and learns to use coping skills.

•
Alternative therapies.
There are a variety of options for fami-

lies who lean toward alternative health care options. Anxiety disor-

ders can be treated with acupuncture, meditation, massage therapy,

and biofeedback.

Where to Get More Help

If you suspect that your child may have SAD, it’s wise to call a pro-

fessional who specializes in working with children. This person can

help you determine if your child would benefi t from a treatment plan.

Your fi rst call can be to your pediatrician or regular health care pro-

vider for a discussion and description of symptoms. Your doctor can

rule out any physical health problems as the source of anxiety and

Extreme Emotions: Separation Anxiety Disorder
145

provide a recommendation to a mental health professional. Be sure

to consider all of the options open to your child. The following orga-

nizations can also provide you with information and guidance:

American Academy of Child and Adolescent Psychiatry

www.aacap.org

American Academy of Pediatrics

www.aap.org

Anxiety Disorders Association of America (ADAA)

www.adaa.org

Your child’s pediatrician, daycare, church, school, or school district

may also have recommendations.

Books for Parents

A number of books have been written for parents about SAD. These

are good references if you are unsure whether your child needs fur-

ther help or if you wish to be better informed during the process of

working with a professional.

Chansky, Tamar E.
Freeing Your Child from Anxiety: Powerful, Practi-

cal Solutions to Overcome Your Child’s Fears, Worries, and Phobias
.

New York: Broadway Books, 2004.

Eisen, Andrew R., Linda B. Engler, and Joshua Sparrow.
Helping Your

Child Overcome Separation Anxiety or School Refusal: A Step-by-

Step Guide for Parents
. Oakland, CA: New Harbinger Publica-

tions, 2006.

Spencer, Elizabeth DuPont, Robert L. DuPont, and Caroline M.

DuPont.
The Anxiety Cure for Kids: A Guide for Parents
. Hoboken,

NJ: J. Wiley, 2003.

This page intentionally left blank

Index

Adult separation anxiety

practicing separations,
24

questionnaire
, 136

telling babies what to expe
ct, 27–
28

Adults-only vacations, planning,

Babysitters

117–
20

preparing house for,
76

Advance visits, separations and
, 57

tips for when child resist
s, 87–9
2

“Alone time,” permitting, for babies

Bedside pet
s, 109

and toddlers
, 27

Bedtime separation anxiety,
63

Annoyance, avoiding showing
, 70–
71

tips for,
105
–12

Anxiety, things that increase overall,

Bedwetting, managing, and sleepovers,

76.
See also
Separation anxiety;

116

Stranger anxiety

Blankets, encouraging relationships

Attachmen
t, 6

with security
, 33–
34

Attitudes, leaving child and,
29

Bond, Felici
a, 67

Autonomy, creating baby steps for,
56

Bonding,
6

Books about similar situations, reading,

Babies, no-cry solutions for,
21.
See also

59

New babies

Bracelets.
See
Magic Bracelets

allowing separations that the child

Brazelton, T. Berry,
100

initiates,
32–
33

Bubble blowing
, 74–
75

avoiding excess separation
, 38–
39

Business travel, tips for handling,

avoiding in-arms transfer
s, 24–
25

126
–27

avoiding prolonged partings
, 28

Bye-bye games, playing,
1

avoiding rushed parting
s, 28

avoiding sneaking away,
28

Call-home plan
s, 117

babying,
25

Children’s books about similar

creating baby steps of autonomy,

situations
, 59, 8
1–
83

55–
56

Chill times, providing
, 63

cueing caregiver’s response
, 31

Clinging, setting limits on
, 77

encouraging relationships with

Coping techniques.
See
Relaxation and

transitional object
s, 33–
34

coping techniques

expressing cheerful, positive attitude

Crawford, Mark
, 54

when leaving
, 29

having child well rested and well

Dacey, John S.
, 61, 6
5

fed,
37–
38

Daddy/Mommy box
, 12

having dress rehearsal
s, 55–
56

Diaries, helping children keep
, 123

having practice sessions
, 30–
31

Distractions, inviting, when leaving,

introducing new people
, 35–
37

31–
32

introducing people gently
, 34–
35

Divorces, tips for handling
, 123–
26

inviting distraction
s, 31–
32

Door ga
me, 83

minimizing separations,
26–
27

Dress rehearsals, for separation
s, 55–
56

monitoring responses of parent
s, 39

DuPont, Caroline M.
, 141

permitting “alone time,”
27

DuPont, Robert L.
, 141

playing bye-bye ga
me, 23

playing peek-a-boo with object
s, 22

Eating schedules, maintaining,
61–
62

playing peek-a-boo with people
, 23

Eisen, Andrew R.
, 4,
74, 1
07,
115

147

148

Index

Embarrassment, separation anxiety

sending child to kindergarten or fi rst

and,
16

grade and
, 102–
3

Emotionally safe children, keeping,

tips for,
46–
47

13–1
4

using
, 47, 4
9

Engler, Linda B.
, 115

weaning child from
, 49–
50

Escolar, Maria Luis
a, 33

Meal times, maintaining schedules for,