Anxiety: Some Old Value for an Asset

(An earlier version of this essay was posted on Behavior OnLine; it is also posted currently at www.clinical-sociobiology.com)

Fear and worry can be very useful for keeping us healthy or for helping us to conserve scarce resources.  Thus, fear is often an emotional tool that is easily triggered by separation from our partners, disease and death, insects and snakes, and scarcity.   Fear can also help us to rein in our demands and to be less conspicuous when we are around people who are larger than we are or who are unpredictable.  Fear will also lead to form special friendships so that we feel protected and safe.

Being frightened (or depressed) also has a powerful effect on people around us.   Crying infants draw help from nearly anyone passing by.  Sadness in children, teens, and adults produces concern, offers of assistance, and an urge from other people to stay closer to you. 

On the other hand, excessive sadness and persistent depression can lead to other people "giving up" and pulling away from you, perhaps while passing you onto a doctor.    As with any emotion, there is a middle range -- too little and you may get hurt, too much and you miss opportunities and may be shunned. (Even fear and anxiety have characteristics of a phase transition -- see postings on complexity theory and emotional distress)

These are guidelines only. Do not use them in the absence of qualified professional coaching.   Medication can be a significant benefit for reducing certain types of fear or for allowing the frightened person to be more assertive while he or she learns Adjustments in the content, intensity, and duration of a procedure will often have to be made because of unique features of the child and his parents.

1. Give the child realistic information about the feared situation and his options for either escape or for controlling his rate of entry into it.

2. Use a large, trusted, skillful "alpha" child or adult, who has an alliance with your client, to come along and lead him through the difficult task. The strength of the alliance and the competence of the guide are probably the most important considerations in choosing one.

3. Make transitions into feared situations slowly. Introduce feared elements in the presence of known comforting elements such as pets, stuffed animals, or a trusted adult. Allow the child to be in the situation for some time before requiring him to participate actively.

4. Give easier tasks before more difficult ones.

5. Involve friends for the transition period. Have them sit with the child or model the behavior that is needed. Let them bring a pet, favorite toy, or stuffed animal to the test condition (provided the other children won't ridicule them). If the child has mastered the task but is still afraid to perform it, try having a younger sibling or a girlfriend come along and perform it with them.

6. Have the child practice the needed behaviors in less public or safer situations.

7. Praise them for being brave. Ask them to praise themselves for being brave.

8. Have them model the behavior for less able students.

9. Find similarities between the target behavior and skills that the child has already mastered. Slowly remove the differences.

10. Use material that shows favorite actors, cartoon characters, or heroes performing the skill.

11. Lower your head level to that of the child when giving directions or explanations. Modulate your vocal quality so that it is "low, close, & slow."

12. Teach Lamaze breathing. Use the "runners" model to get the pacing correct; that is, exhale on every other step while walking. Later, they can pretend to run while breathing in synchrony with their imagined pace.

14. Allow a "good luck" piece.

15. Early memories ... most of us lapse into chuckles or relaxation when we review earlier memories of old friends, an outrageous accomplishment, or a favorite partner. The effect is instantaneous, powerful, and currently unappreciated -- indeed, unrecognized -- in the clinical literature. Early memories can be useful for disrupting obsessing about fear and embarrassment in some children or adults

16. "Cognitive Therapy" -- a geological event but still not understood. (More later!)

17. Fear of losing your mind -- probably the largest of any fear because it leads to helplessness, a condition that causes ulcers in rats and tears in human mothers. Pinpointing the location, thoughts, intensity, and duration of the smaller fears transforms them into predictable events. With prediction comes a sense of control whether by talismen or by rational strategies. Beat the "craziness" fear and all other fears become markedly smaller
Copyright, James Brody, Ph.D., 1998. Jbrody@compuserve.com

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