iLs Clinical Director, Ron Minson, MD discusses strategies from his experience working with children dealing with Separation Anxiety Disorder.
iLs: What is Separation Anxiety Disorder and can you give an example of what it is like for the person who suffers from it and their family?
Dr. Minson: Separation Anxiety Disorder is a medical condition. The person who suffers from it experiences extreme discomfort and anxiety when separated from their parents or caregivers. The same excessive agitation can be experienced even when anticipating leaving home or separating from primary caregivers. This disorder affects up to five percent of children.
Children and adolescents with separation anxiety disorder have a particularly hard time with the start of school. Long tearful goodbyes make them late; they often miss school, overcome by anxiety and inability to leave home; they avoid activities at school and are reluctant to join in with peers. These troubles trigger a downward spiral leading to low self-esteem and poor concentration.
I am reminded of Suzie, the 3-year-old younger sister of a child I was seeing for dyslexia. When her mother tried to accompany her older daughter into my office, Suzie had a tantrum, screaming and yelling at the top of her lungs. Any attempt to console her or attempt to separate her from her mother was met with an increase in her panic reaction. And, the mother’s distress was second only to that of her daughter.
Initially, the only solution was to allow Suzie to accompany her mother into my office. Later, she was able to separate for brief periods that became longer over time, as she accepted a picture of her mother in place of the real person. Also, she was comforted by her “blankie” that she slept with and carried around everywhere at home but not outside. Part of the therapy was to allow Suzie to carry the blankie with her at all times, just like Linus in the Peanuts cartoons.
iLs: How can you tell the difference between simple nervousness about the start of a new experience and an actual disorder?
Dr. Minson: A certain amount of discomfort over separating from family is experienced by all children and even adolescents. Infants begin to show signs of it at 6-8 months when they become uncomfortable meeting strangers and it may last until age two when the child has accumulated adequate experience with unfamiliar people and situations. And in young children, experiences like vacations or illnesses may heighten difficulties with separation.
But with true Separation Anxiety Disorder, the child is expressing a full blown panic attack with all the physiologic manifestations of fear triggered by separation from the primary caregiver, usually the mother. There is a marked increase in heart rate, sweating, muscle tension and a refusal to let go or separate. A full blow tantrum is typical. The body and emotional reactions far exceed the anticipatory anxiety with encountering unfamiliar situations.
iLs: What resources are available to work with children who have a separation anxiety disorder? Are they effective?
Dr. Minson: If possible, try to avoid separation anxiety developing in the first place. Importantly, separate from your child for brief periods during infancy, gradually lengthening the time apart. For example, date night for parents during the child’s early development is important.
Once the disorder has set in, play therapy with an experienced child therapist can be extremely beneficial. Using familiar objects like the blanket mentioned earlier or a teddy bear or other loved object can do wonders to help with the transition from fear to normal anxiety. Parents need support for their child’s separation anxiety too. Parent groups and couple’s therapy can be very instructive and supportive.
iLs: Can iLs help with a child experiencing separation anxiety?
Dr. Minson: Yes. iLs helps to reset the nervous system’s tendency to go immediately into fear through its proven effect in physiological calming and decreasing sympathetic flight/fight responses. It is most appropriately used in conjunction with other therapies.
Watch a video with Dr. Minson and Dr. Hallowell discussing how iLs affects the nervous system.
Learn how the Dreampad can reduce anxiety and improve sleep as children get back into school.