• Trilby Yonkovitz

Phobias in Children: How to Help



We all have fears. No matter our age, there is something out there that puts us out of our comfort zone, something that ties a knot in our stomach. Whether it be something physical, such as heights, or a concept, such as being rejected, fears still exist. As humans, we have a built in system to protect us from scary or dangerous situations. We jump when we hear an unfamiliar noise, we duck when something is about to hit us, and we can even sometimes tell when something feels off. Our minds are always working to protect us from unsafe situations.


As an adult, you may have found a way to cope with your fear, or to just avoid it in general. Simply letting go of a fear is hard enough for an adult, how difficult must it be for a child? You may view the fears that children have, the monster under the bed, the dark, or even vegetables, as silly and dismiss it as their imagination. You may not think it compares to real world dangers or stress. However, in hindsight, adults have plenty more years to learn about their fears, and to fight them. Some adults may have even grown out of some of their fears from childhood.


As a parent, you want nothing more than your child to be brave, to feel protected and safe when it comes to their fear. You tell them not to worry about it or to just not think about it. You give them the same coping strategies you use with your fears. You help distract them. Over time most fears are at least stabilized, children, and adults, don't like their fears, but they learn to live with them.


What happens when thinking the fear away doesn't work? What if its just not situational but more persistent? What if this fear affects all areas of your child's life? What if time doesn't heal the fear? What if the fear is a little unrealistic, or doesn't propose immediate danger? Sometimes instead of shrinking, or being maintained, children's fears grow until it is invasive and difficult to enjoy life. This is when a fear becomes a phobia.


What is a Phobia?


Phobias are more than just being afraid or not liking something specific. As stated by the American Psychiatric Association, a phobia is an irrational and excessive fear of an object or situation. Phobias last longer than fears, at least six months. This is why fears, such as being afraid after watching a scary movie for the night, is not considered a phobia.


There are many categories of phobias, a lot of times dealing with animals, the medical world, the natural world, people, and specific situations. According to the Boston Children's Hospital, the most common phobias for children include animals, the dark, small spaces, flying, getting sick, having a family member get sick, heights, insects, needles, blood, and storms. A child's phobia is unique to themselves, two phobias of the dark may stem from totally different experiences, or have different intensities. Phobias develop from different sources. A bad initial interaction with an object, animal, or situation, could cause a phobia to develop. Other reasons may be an anxious temperament, childhood trauma, physical health conditions, or a family member with a phobia.


Symptoms of phobias are essentially amplified nervous reactions whenever the phobia is present. Like the categories, symptoms are unique to the person. Common symptoms include sweating, increased heart rate, trouble breathing, stomach pain, feeling faint, fear of death or losing control, freezing up, or suddenly feeling very cold or hot. Many children may describe phobia symptoms as feeling sick, or may showcase behaviors to avoid the phobia at all costs. This could result in adults seeing the symptoms as an act rather than serious. A child's healthcare provider is someone who could correctly diagnose a phobia.

How to Help Your Child With Their Phobia


Children can benefit from therapy to help with phobias. Cognitive Behavioral Therapy, CBT, and Family Therapy are two therapy treatment models used with working with phobias. CBT helps children learn relaxation techniques and coping skills, while Family Therapy can help the family support one another and communicate. Getting school staff involved in treatment may be helpful as well, especially if the phobia is situational. Here are some tips to help your child with their phobia at home.


  1. Phobia Box, Hope Box. Ask your child to come to you when they are feeling anxious about the phobia. Now in your room you will have two boxes, a phobia box and a hope box. The boxes are in the parent's room because that is where they are kept safe and out of the child's direct contact. When your child comes to you expressing thoughts, or concerns about a phobia, ask them to write it in a slip of paper. The written phobia is then deposited into the phobia box. In exchange for making a deposit into the phobia box, the child now gets to pick an already written slip of paper out of the hope box. The hope box should always be stocked with papers that either have coping skills, positive affirmations, or distraction activities written on them.

  2. Give Structured Time. When a phobia is situational, such as a storm or going to the doctor, be sure to give your child a heads up. Come up with a structured check list with your child (ex. get outside shoes on, take deep breaths, say some positive affirmations) that becomes a routine to help fight the phobia.

  3. Draw It Out. Spend some time with your child doing an art activity. Have your child draw out the phobia in pencil, while you draw something that you find scary or annoying. Next step, draw another picture, with crayons, markers, or colored pencil making the phobia funny, colorful, or silly. You can suggest funny things to turn your child's phobias into. If your child has a phobia of needles, you can both turn a drawing of needles into a pastry bag with icing. If your child is afraid of dogs, you can make the dogs singing instead of barking.

  4. Identifying the Emotions and Intensity. Talking fears out is one of the best ways to overcome them. Encourage your child to talk about their fears with you and help them identify the emotions behind the fear. You can print out, or purchase, a feelings chart to use at home with your child. This will help your child learn the 'building block' emotions behind their fear, and therefore be able to cope with them. You can also ask your child to rate their intensity of their phobia to you on a scale of 1-10. A rating of 10 could result in a coping skill as a family, while a lower rating you could encourage a more independent coping skill. With family support and identifying emotions, your child's rating intensity should decrease over time.

  5. Be Supportive. This is probably the most important tool in your family's phobia fighting toolbox. When children believe in and feel their parents helping them conquer a phobia, it helps them become confident in their abilities. Don't dismiss your child's phobia. Don't just tell them that they are overreacting or to calm down. Each time you talk with your child about their phobia, ask yourself if your reaction will help connect more or disconnect more with your child.


References

Boston Children's Hospital. (2020). Phobias Symptoms & Causes: Boston Children's Hospital. Retrieved October 29, 2020, from https://www.childrenshospital.org/conditions-and-treatments/conditions/p/phobias/symptoms-and-causes


Cedars-Sinai. (2020). Phobias in Children. Retrieved October 26, 2020, from https://www.cedars-sinai.org/health-library/diseases-and-conditions---pediatrics/p/phobias-in-children.html


Cherry, K. (2020, February 03). How Phobias or Persistent and Extreme Fears Are Treated. Retrieved October 29, 2020, from https://www.verywellmind.com/what-is-a-phobia-2795454


Kids Health. (2020). Anxiety, Fears, and Phobias. Retrieved October 26, 2020, from https://www.hopkinsallchildrens.org/Patients-Families/Health-Library/HealthDocNew/Anxiety,-Fears,-and-Phobias




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Trilby Yonkovitz

Harvest Family Therapy LLC

Sherry Kay Fulmer

Fulmer Family Therapy LLC