Anxiety can be like a Chinese finger trap. Try to break free with panicky pulls and it’ll just get worse. But approach it with a calm mind and a bit of patience and you’ll be out in no time.
That metaphor is a go-to for psychotherapist Robin Kirk, who counsels clients suffering from social anxiety, obsessive compulsive disorder and phobias. With 20 years of experience in anxiety disorders, Kirk is the director of Sage Psychotherapy Associates, which she founded in Sacramento three years ago. This fall, as the stress of the academic year takes hold, Kirk is helping some of her young patients learn new coping strategies.
In a blue-and-earth-tone office space near the California State University, Sacramento, campus, Kirk and her staff use a combination of “acceptance and commitment therapy” (ACT) and “exposure therapy.” Anxiety is largely a worry about the future, Kirk said, so ACT helps children and teens stay grounded in the present through meditation and self-awareness exercises.
The exposure therapy that follows brings patients face-to-face with the source of stress – a homework assignment, perhaps – and helps them acknowledge that the anxiety is there without feeling like they have to indulge it or struggle against it, she said.
Anxiety disorders affect one in eight children, according to the Anxiety and Depression Association of America.
At Sage, kids and teens have access to a meditation room, a group lounge and a number of stations where they can simulate anxiety-inducing situations, such as getting ready in the morning, preparing food in a kitchen or doing work at a desktop computer.
The Bee sat down with Kirk to discuss red flags for anxiety and what families can do to help.
How can parents spot anxious behavior, and how should they respond if they do?
Let’s say a parent has a child who is slow to get ready in the morning. They might have to take a shower for an extra long time or wash themselves in a particular way. Or they may have trouble packing their backpack because they’re checking their homework a bunch of times. Or a child who maybe doesn’t turn in their homework because they have a really hard time getting started because they have to do it perfectly, and it gets so daunting that they just don’t hand things in.
Our weekly group helps parents to identify these signs and learn how to respond to them. A lot of the time, what’s a natural and seemingly loving way to respond is to try to make the child feel better ... (but) it can actually strengthen the anxiety instead of relieving it. It’s what most of us do when someone we love is in distress.
So that protective behavior can be a bad thing?
If there’s a child with perfectionism – maybe they re-read the same chapter 15 times to make sure they have it – the reassurance doesn’t help. It can be hard for parents to disengage if they’re used to trying to make it better and have to take a step back.
Some parents will do the compulsion for the child. If a child has contamination issues, the parent will open the door first. It seems like a good thing, but it’s really a bad thing. They’re not facing the fear.
How can the start of school act as a trigger for anxiety?
If a child is at home all summer and things are pretty routine and predictable, the family may have made adaptations to keep the child calm. They go into an environment that has a lot of unknown factors that they can’t control, so their anxiety skyrockets.
You mentioned that you’d like to start bringing your program into schools. How does a school’s staff generally handle an anxious child’s needs?
There are school counselors, but especially these days with budget cuts, they’re stretched pretty thin. Part of it is providing in-services to teachers so they know what to look out for. A teacher might not even think to refer a child to the counselor just because he’s frequently asking for a hall pass. … The children with the anxiety disorders are often not the troublemaking ones, so they can be easily overlooked or ignored.
How can the home environment compound anxiety that’s already occurring at school?
If there’s a predisposition at home to doing everything perfectly, that environment can definitely impact the child. We notice it starting really early. By fifth and sixth grade, children will start getting worried about college admission in their grades. Once they are taking AP classes – plus they also need to be doing community service and SAT classes – that puts a tremendous pressure on them. And the parent thinks, “We have to keep the pressure on or they won’t get into the college of their choice and they won’t be successful.”
What usually drives a parent to bring his or her child to your practice?
Often when someone brings their child in, they’re not doing as well as the parents think they could. Or they have a 4.6 (grade point average) but they’re crying all the time and can’t sleep and have no social life. So they’re noticing that something is amiss. … They’re willing to say, “Let’s try something else.”
What’s changed in recent years that might be causing these reactions?
At school, there can be so much of a focus on the outcome that’s way down the road rather than (on) the process of learning. It can take the passion for learning out of the equation while also inhibiting the development of curiosity and self-exploration. It becomes all about admission standards and competition.