Phobias can be an enormous encumbrance for young children, cause immeasurable distress to parents and offer huge challenges for practitioners.
With an estimated 1 in 30 children suffering from phobias to some degree they are one of the most common anxiety disorders. Defined by an extreme and intense fear of a particular animal, object or situation a phobia is usually a fear of something which holds little or no fear to others and is therefore considered irrational.
As adults we are all familiar with irrational fears. Most of us could write a short list of objects or situations we are afraid of which may seem illogical to others; ghosts or spiders perhaps. The key difference with a phobia is that it makes the sufferer feel extreme anxiety, even terror, at the thought of coming in contact with their feared object or situation. When phobic the body enters the ‘fight or flight’ state, caused by adrenalin and other chemicals being released into the body. This evolved anxiety defense mechanism is designed to protect in times of danger and is a vital part of psychological growth. However phobia sufferers enter this ‘fight or flight’ state without any real need. It’s as if the brain is playing a trick which has a huge physical impact and can result in severe anxiety.
Common phobias in under 5s include the dark, animals, heights, blood, injections, fictional characters and the toilet. When presented with the phobic situation or object the child experiences hugely unpleasant anxiety symptoms and will therefore go to all lengths to avoid it. It is this avoidance which is the real problem as it can interrupt their day-to-day activities.
Researchers remain unsure of the exact root cause of phobias. Some suggest a genetic link as studies on identical twins demonstrate that many share the same phobias even when raised apart. There are also cultural factors to consider, for example in Japan there is a phobia of offending others in social situations; this one appears to be exclusive to the Japanese. Life experiences are often cited as the route cause. Children in particular are quick to make generalisations. So, for example, a bad experience with one over-zealous dog may result in all dogs being branded ‘mean’ or ‘scary’.
Parents and practitioners are usually pretty sharp at spotting when a child is excessively uneasy or worried about something. The specific symptoms of phobias can include; obsessions, nausea, rapid breathing, headaches, stomach ache, pounding heart, faintness and sweaty palms.
All children have fears; be it the ‘monster’ under the bed, fear of the dark, of ghosts or going to the toilet alone. These fears are often fairly transient and disappear by themselves over the course of time as the child gains a greater understanding of the world around them. If the fear seems age-appropriate then chances are it will diminish with time. If the fear is uncommon with their age-group and distinctly persistent more concern is perhaps warranted.
How much the fear affects the child in their life is also a relevant consideration. Phobias can create mayhem for the child; affecting nursery, home life and friendships.
By being supportive and discussing the fear practitioners and parents can often reassure the child that although the fear is understandable there is nothing to be afraid of. Through rational and calm conversations the phobia will often subside over time. However professionals acknowledge that if the phobia is causing the child extreme distress, if it is impacting on their day-to-day life or if it occurs alongside other anxiety-related issues then it’s time to seek advice. Concerned practitioners should discuss with a SENCO or Educational Psychologist in the first instance with the aim of getting a second opinion and some advice. Treatments on offer from Psychologists include Cognitive Behavioural Therapy (working on and correcting thought processes) and Psychotherapy (finding the route cause).
Response from Practitioners
Never belittle the fear; saying “don’t be silly” or “nobody’s afraid of …” is not helpful and will only serve to increase the anxiety. Conversely though, don’t cater to the fear. If the child is afraid of something, helping them to deliberately and obviously avoid it will enforce the notion that there is something to be afraid of.
Also try to ‘desensitise’. This is a technique employed by Cognitive Psychologists which involves gradual exposure to the feared object or situation, the aim is to help them to take progressive steps to overcome the fear.
Many fears are based on mis-conceptions. Through talking with them there may be a Eureka moment created where something is explained and clicks with them, reducing the fear significantly. Always be wary of offering too much attention due to the phobia though. This attention may act as a reward and further increase the phobic symptoms.
A wider view of phobias
Historically childhood phobias were dismissed as ‘phases’ that were a normal part of child development. Piaget, famed for his work on child cognition, believed that 2-4 year olds weren’t able to formulate concepts, what he called the ‘pre-conceptual period’. Therefore children were seen to have immature reasoning skills. This was believed to explain, for example fears of spiders if they had seen someone else have this fear, or fear of the dark if they had once been read a scary story at bedtime. The emphasis on ‘stages’ meant that it was assumed all children would ‘grow out’ of these anxieties. Today most professionals take the balanced view that although most phobias will diminish with time, and are as Piaget suggested age-appropriate phases, a phobia which continually has negative consequences and is the source of acute anxiety, requires treatment.
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