Chapter 2

How Do Thoughts and Feelings Affect Anxiety?

The First Steps Toward Learning Anxiety Management Skills

There are some simple pieces of information that can really help children learn to manage their anxiety better. Younger children might need to spend a little more time in this section, whereas older children might cover it fairly quickly.

Learning About Feelings

Many children have difficulty in naming feelings and in being able to describe the differences between emotions. It’s important to make sure that your child understands and can recognize different emotions before moving on to teach ways of controlling anxiety. You can help your child by labeling and discussing feelings in everyday situations and by playing games based on feelings. The first children’s activity for this week shows some different emotions to get you started. You might also try some other ways to get your child to think about different feelings. For example, play a game where your child acts out a feeling, first just being given the name of the feeling (e.g., sad, angry) and then being given a situation (e.g., winning a prize, losing a wallet). Your child then acts out the feeling he or she would probably have in that situation. Try to make it fun and silly. If the rest of the family is willing to get involved, you can make a set of cards or pieces of paper with different feelings written on them and have each person take turns in picking one of the cards and acting out that feeling without using words. Other members of the family can then try to guess what the feeling is.

Your child should learn that there are several different forms of anxiety. For example, fear, worry, tension, shyness, embarrassment, and terror all have a focus on possible danger at their core. While there may be slight differences between them, as far as this program is concerned, they are all basically the same.

The Worry Scale

An important step is to teach your child how to measure his or her fears. This will help your child understand that strong emotions do not come from nowhere or “out of the blue.” In addition, your child needs to learn that we are not trying to “get rid of” anxiety, but are simply teaching him or her to control it better. So being able to distinguish between different levels of fear will become important later in the program.

We use the worry scale to show different degrees or levels of anxiety. In activity 7 you will teach your child about this scale. The thermometer uses a scale from 0 to 10 on which different levels of anxiety are marked from 0 (very relaxed) to 10 (extremely worried). This is a personal judgment, and everyone will have different perceptions for different situations. What is important is that your child learns to recognize that anxiety is not an all-or-nothing feeling but can vary in degree.

After teaching your child about the worry scale (using this chapter’s activities), it is important to have your child practice giving worry-scale ratings. Ask your child how anxious he or she is in different situations through the day. This will help your child to become more aware of his or her anxiety levels and will also give the two of you a common language to use to describe anxiety (e.g., “I feel at 4 now” or “I’m at 7 at the moment”).

How Anxiety Affects Your Child

We have already described for you how anxiety can affect a person. We discussed the idea that anxiety affects three different aspects of a person—body, behavior, and thoughts. It is also important for your child to develop an understanding of this lesson by becoming aware of how anxiety affects him or her. At your anxiety management session for this week, begin by teaching your child about how anxiety might affect him or her across the three systems—physical symptoms, thoughts, and behaviors. Some of the information you might cover follows.

How Anxiety Affects the Body

When we become frightened, our body goes through many changes. These may include any of the following:

• Breathing fast
• Butterflies in tummy
• Needing to go to the toilet
• Wobbly knees
• Tense muscles
• Dizziness
• Crying
• Sweating
• Stomachache
• Shakiness
• Headache
• Feeling too hot
• Fidgetiness
• Increasing heart rate
• Blushing

You can begin to get younger children to think about these changes by asking them to think of a frightened animal such as a cat. Ask what physical changes would happen if a cat was asleep and woke up suddenly to see a dog standing next to it (e.g., fur standing up, big eyes, tensed-up body, and scared expression). After this you can ask your child to think about how his or her own body feels during anxious times. It is often useful if you or other family members are willing to discuss what happens to your and their bodies when anxious, to show both the similarities and the differences in how people react to anxiety. Activity 8 at the end of this chapter will help you and your child identify these reactions.

How Anxiety Affects Thoughts

It is also going to be important for your child to become more aware of his or her worried thoughts and beliefs. In fact this is one of the more important parts of this section since you will be moving on in later weeks to help your child change his or her anxious thoughts. Your child will learn that certain feelings go along with certain thoughts and that anxious feelings tend to go along with thoughts of danger. In addition, your child needs to begin to become more aware of the particular bad things that he or she tends to expect. When teaching your child about thoughts, try to get him or her to suggest thoughts that indicate some sort of event rather than simply describing the feeling. For example, a thought such as, “This is going to hurt” is good because it describes a bad outcome that a person might be expecting. However, a thought such as, “I am scared,” which simply describes the feeling, doesn’t tell you anything about what your child is scared about. One of the hardest things for children in this part of the program is to learn the difference between thoughts and feelings, so it is best to try not to confuse these things. It is a good idea to introduce the term “worried thoughts” here. Your child should begin to understand that when we feel scared, nervous, or shy, it is because we have some sort of worried thought or belief. Of course sometimes these worried thoughts might be quite hard to identify, and some children will say “I just feel that way.” If your child does this, don’t push it yet. It is enough in this case to get your child to “guess” what he or she might be thinking. The concept of worried thoughts will become important later in the program.

How Anxiety Affects Behavior

It is a good idea to get your child to think about how he or she behaves or acts when anxious. This is likely to include different ways of avoiding or escaping from the frightening situation but may also include other behaviors such as pacing, hitting, throwing tantrums, asking for help, or biting nails. To try to raise your child’s awareness of what he or she typically does when anxious, first tell your child what you do, then ask what he or she thinks someone else in the family does, before finally asking what it is that he or she typically does. As with worried thoughts, some children may not recognize or admit to all their behaviors. Again, don’t push too hard at this stage.

Parent Activity: Learning About My Child’s Anxiety Patterns

Since you are going to be helping your child through this program, it is a good idea for you to learn a little more about these patterns as well.

To help with this, on a separate piece of paper, create a table with the headings “Situation,” “What does my child usually say or ask?” “What doesn’t my child do because of fear or worry?” and “What does my child think will happen?” Then, over the next few days, watch your child carefully—keeping in mind his or her anxious behaviors, thoughts, and feelings—and complete the table.

Based on the gathered information, what is it about your child that alerts you to the fact that he or she is worried or scared (think about typical things he or she says, physical symptoms, mood swings, etc.)?

______________________________

______________________________

______________________________

______________________________

______________________________

______________________________

______________________________

______________________________

______________________________

______________________________

______________________________

______________________________

______________________________

This information will also be helpful during later activities, so keep it handy.

Linking Situations, Thoughts, and Feelings

Once your child has learned the different ways that anxiety affects him or her, the next step in the program is to help children to understand that there is a link between a situation, their thoughts, and how they are feeling. To do this successfully, your child will need to be able to identify situations that he or she has been in, what he or she thought during that time, and how he or she was feeling in that situation. This is the first skill that will require a short period of daily practice before your child will be able to confidently identify thoughts separate from his or her feelings.

We use a form to help children record the link between situations, thoughts, and feelings. The following is a completed example. The form asks children to describe the situation that made them frightened, their thoughts at the time, how they actually felt (e.g., frightened, worried, shy, nervous, etc.), and the degree of fear or worry on the worry scale.

Activities to Do with Your Child …

Children’s Activity 6: Learning About Feelings

Use a magazine with many pictures of people in it (National Geographic is very good for this or use the cartoon faces provided in the workbook at www.ceh.mq.edu.ua/hyac.html) to start a conversation on the different types of feelings that people can have. Try to encourage your child to use a variety of feeling words. After naming many feelings, play a game of feelings charades: concentrate on using body language and facial expressions to express feelings, and have your child guess the feeling as well as act ones out for you. To get started, write feelings on pieces of paper and take turns pulling them out of a hat.

Children’s Activity 7: The Worry Scale

Show your child the worry-scale thermometer included on the next page or in the workbook. Explain to your child that sometimes we only feel a little bit worried, but at other times we feel really, really scared. So that we can tell other people how scared we are very quickly, we can rate the feeling of worry on a worry scale, just like you can read the temperature on a thermometer. Have your child use the worry scale to describe his or her degree of worry in a list of different situations, including silly ones (like waking up and finding that a lion is in the bed), ones that are likely to get a very low rating (such as visiting Grandma for her birthday), and situations that you know your child finds very frightening. Make sure your child is giving ratings across the range on the worry scale.

Reprinted with permission from the Centre for Emotional Health, Macquarie University, Sydney, Australia.

Children’s Activity 8: Anxiety and My Body

Create an outline of a body that your child can use to show where anxiety affects him or her. You may choose to draw one freehand, but a fun alternative is to get a huge sheet of paper, have your child lie on it, and then draw an outline of your child with a pen on the paper. Your child can then use this personal “portrait” to color and show where and how anxiety affects him or her. If needed, use the list from the section “How Anxiety Affects the Body” to remind your child of possible body symptoms. Help your child feel okay about these symptoms by comparing them to the ones that you get when worried or scared.

Children’s Activity 9: How Anxiety Affects My Thoughts

Talk with your child about how feelings depend on what you are thinking. Look at magazine pictures and ask your child how the person is feeling and then have him or her guess what that person might be thinking. Using pictures of situations that could be either positive or negative, such as a child ice skating (cartoons of these situations are provided in the workbook). Ask your child to identify a thought that would make the person feel happy and then a thought that might make the person feel worried or scared. You may need to do this several times for your child to easily identify thoughts for different situations. At the end of the activity, point out how different people can have different thoughts and that even the same person can have different thoughts about one situation.

Children’s Activity 10: Linking Thoughts and Feelings

Draw a table with the headings “What happened?” “What was I thinking?” “What was I feeling?” or pictures similar to the square, thought bubble, and heart in the picture on page 53. Then ask your child to think of a time when he or she felt really happy and relaxed and to think about where he or she was, who was there too, and what they were doing. Write a short description of the situation in the first box. Now ask your child to try to remember what he or she was thinking or saying to him- or herself in his or her head. This might be a bit hard to remember if the situation happened a long time ago. If your child can’t remember exactly what he or she was thinking, try to guess what it might have been in that situation. Write this in the “What was I thinking?” box. Then ask your child to indicate how he or she was feeling. Write this in the “What was I feeling?” box. Finally, have your child rate how worried he or she was in this situation using the worry scale (probably 0).

Next, repeat this exercise having your child think of a time when he or she felt terribly worried or afraid. Finally have your child describe a situation that has happened in the past day or two and ask your child to tell you what he or she was thinking and feeling. You may complete several examples from the past few days to help your child understand that thoughts are related to feelings.

Children’s Practice Task 1: Learning About My Thoughts and Feelings

As we said before, it’s important for your child to learn to become more aware of his or her own patterns of anxiety. You can do this by having your child keep a record of his or her anxiety for a week or two, recording a number of examples of situations, thoughts, and feelings that bothered him or her. Use a picture or table like the one in activity 10 and have your child make an entry on the sheet whenever he or she feels anxious, worried, shy, or scared, even if only a little. This may be many times a day or only once a day. But you should try to encourage your child to make at least one entry each day. Remember to praise and reward your child for these efforts during the week.

Chapter Highlights

In this chapter, you and your child learned …

• How to recognize and distinguish between different types of feelings
• How to use the worry scale to rate the intensity of anxious feelings
• What happens to your body when you are anxious
• That in each situation where you feel anxious, you have a worried thought that causes the bad feeling

Your child will need to do the following:

• Complete the children’s activities with the help of a parent or other adult.
• Complete Practice Task 1. Fill out the table that you put together in activity 10 at least once per day for at least one week. (A worksheet for Practice Task 1 is provided in the workbook on the Internet at www.ceh.mq.edu.au/hyac.html and is called “Learning About My Thoughts and Feelings.”)