How to raise kids who can overcome anxiety
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0:01 - 0:04As a child, I had many fears.
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0:05 - 0:07I was afraid of lightning, insects,
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0:07 - 0:10loud noises and costumed characters.
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0:10 - 0:14I also had two very severe phobias
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0:14 - 0:16of doctors and injections.
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0:17 - 0:20During my struggles to escape
from our family doctor, -
0:20 - 0:23I would become so physically combative
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0:23 - 0:26that he actually slapped me
in the face to stun me. -
0:26 - 0:27I was six.
-
0:28 - 0:31I was all fight-or-flight back then,
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0:31 - 0:35and holding me down for a simple vaccine
took three or four adults, -
0:35 - 0:36including my parents.
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0:38 - 0:42Later, our family moved
from New York to Florida -
0:42 - 0:44just as I was starting high school,
-
0:44 - 0:46and being the new kid
at the parochial school, -
0:46 - 0:48not knowing anyone
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0:48 - 0:50and being worried about fitting in,
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0:50 - 0:52on the very first day of school,
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0:52 - 0:56a teacher takes roll and calls out
"Anne Marie Albano," -
0:56 - 0:58to which I respond,
[In a Staten Island accent] "Here!" -
0:58 - 1:02She laughs and says,
"Oh, precious, stand up. -
1:02 - 1:05Say D-O-G."
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1:05 - 1:07And I respond,
[In a Staten Island accent] "Dog?" -
1:07 - 1:11The class broke out in laughter
along with the teacher. -
1:11 - 1:13And so it went,
-
1:13 - 1:16because she had many more words
to humiliate me with. -
1:17 - 1:19I went home sobbing,
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1:19 - 1:21distraught
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1:21 - 1:23and begging to be sent back to New York
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1:23 - 1:25or to some nunnery.
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1:25 - 1:29I did not want to go back
to that school again. No way. -
1:29 - 1:31My parents listened
-
1:31 - 1:36and told me that they would investigate
with the monsignor back in New York, -
1:36 - 1:40but that I had to keep going in each day
so I'd have the attendance record -
1:40 - 1:43to transfer to ninth grade
on Staten Island. -
1:44 - 1:48All of this was before
email and cell phones, -
1:48 - 1:51so over the next several weeks,
-
1:51 - 1:57supposedly, there were letters being sent
between the Archdiocese of Manhattan -
1:57 - 1:58and Miami
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1:58 - 2:00and with the Vatican,
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2:00 - 2:04and each day, I'd go into school crying
and come home crying, -
2:04 - 2:08to which my mother would give me an update
from some cardinal or bishop -
2:08 - 2:12to "Keep her going to school
while we find her a spot." -
2:13 - 2:15Was I naive or what?
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2:15 - 2:16(Laughter)
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2:16 - 2:20Well, after a couple of weeks,
one day, while waiting for the school bus, -
2:20 - 2:22I met a girl named Debbie,
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2:22 - 2:24and she introduced me to her friends.
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2:25 - 2:28And they became my friends,
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2:28 - 2:30and, well, the Pope was off the hook.
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2:30 - 2:31(Laughter)
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2:31 - 2:34I began to calm down and settle in.
-
2:35 - 2:40My past three decades
of studying anxiety in children -
2:40 - 2:44stems partly from my own search
for self-understanding. -
2:44 - 2:45And I've learned much.
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2:46 - 2:53For young people, anxiety is the most
common childhood psychiatric condition. -
2:54 - 2:58These disorders start early, by age four,
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2:58 - 3:04and by adolescence, one in 12 youths
are severely impaired -
3:04 - 3:08in their ability to function at home,
in school and with peers. -
3:09 - 3:12These kids are so frightened,
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3:12 - 3:13worried,
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3:13 - 3:16literally physically uncomfortable
due to their anxiety. -
3:17 - 3:20It's difficult for them
to pay attention in school, -
3:20 - 3:22relax and have fun,
-
3:22 - 3:23make friends
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3:23 - 3:25and do all the things
that kids should be doing. -
3:26 - 3:29Anxiety can create misery for the child,
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3:29 - 3:34and the parents are front and center
in witnessing their child's distress. -
3:36 - 3:40As I met more and more children
with anxiety through my work, -
3:40 - 3:44I had to go back to mom and dad
and ask them a couple of questions. -
3:44 - 3:46"Why did you hold me down
-
3:46 - 3:49when I was so frightened
of getting injections -
3:49 - 3:51and force them on me?
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3:51 - 3:55And why tell me these tall tales
to make me go to school -
3:55 - 3:58when I was so worried
about being embarrassed again?" -
3:59 - 4:04They said, "Our hearts
broke for you each time, -
4:04 - 4:07but we knew that these were things
that you had to do. -
4:08 - 4:11We had to risk you becoming upset
-
4:11 - 4:15while we waited for you
to get used to the situation -
4:15 - 4:17with time and with more experience.
-
4:18 - 4:20You had to get vaccinated.
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4:20 - 4:22You had to go to school."
-
4:23 - 4:25Little did my parents know,
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4:25 - 4:29but they were doing more
than inoculating me from the measles. -
4:30 - 4:35They were also inoculating me
from a lifetime of anxiety disorders. -
4:37 - 4:41Excessive anxiety in a young child
is like a superbug -- -
4:41 - 4:45and infectious, even multiplying,
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4:45 - 4:47such that many of the youth that I see
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4:47 - 4:52come in with more than one anxiety
condition occurring at the same time. -
4:52 - 4:54For example, they'll have specific phobia
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4:54 - 4:58plus separation anxiety
plus social anxiety all together. -
4:59 - 5:01Left untreated,
-
5:01 - 5:05anxiety in early childhood
can lead to depression by adolescence. -
5:06 - 5:11It can also contribute
to substance abuse and to suicidality. -
5:12 - 5:14My parents were not therapists.
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5:14 - 5:16They didn't know any psychologists.
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5:17 - 5:23All they knew is that these situations
may have been uncomfortable for me, -
5:23 - 5:24but they were not harmful.
-
5:25 - 5:30My excessive anxiety would harm me
more over the long term -
5:30 - 5:34if they let me avoid
and escape these situations -
5:34 - 5:37and not learn how to tolerate
occasional distress. -
5:38 - 5:42So in essence, mom and dad were doing
their own homegrown version -
5:42 - 5:43of exposure therapy,
-
5:44 - 5:48which is the central and key component
-
5:48 - 5:50of cognitive behavioral
treatment for anxiety. -
5:51 - 5:56My colleagues and I conducted
the largest randomized controlled study -
5:56 - 6:00of the treatments of anxiety
in children ages seven to 17. -
6:01 - 6:07We found that child-focused
cognitive behavioral exposure therapy -
6:07 - 6:11or medication with a selective
serotonin reuptake inhibitor -
6:11 - 6:14are effective for
60 percent of treated youth. -
6:15 - 6:20And their combination gets 80 percent
of kids well within three months. -
6:21 - 6:23This is all good news.
-
6:23 - 6:25And if they stay on the medication
-
6:25 - 6:29or do monthly exposure treatments
as we did in the length of the study, -
6:29 - 6:31they could stay well
for upwards of a year. -
6:33 - 6:36However, after this treatment study ended,
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6:36 - 6:41we went back and a did
a follow-up study of the participants, -
6:41 - 6:45and we found that many of these kids
relapsed over time. -
6:45 - 6:49And, despite the best
of evidence-based treatments, -
6:49 - 6:53we also found that for about
40 percent of the kids with anxiety, -
6:53 - 6:56they remained ill throughout
the course of the time. -
6:57 - 7:01We've thought a lot about these results.
-
7:02 - 7:04What were we missing?
-
7:05 - 7:08We've hypothesized that because
we were focusing -
7:08 - 7:12on just child-focused intervention,
-
7:12 - 7:16perhaps there's something important
about addressing the parents -
7:16 - 7:18and involving them in treatment, too.
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7:20 - 7:24Studies from my own lab
and from colleagues around the world -
7:24 - 7:26have shown a consistent trend:
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7:27 - 7:31well-meaning parents
are often inadvertently drawn into -
7:31 - 7:33the cycle of anxiety.
-
7:33 - 7:37They give in, and they make
too many accommodations for their child, -
7:37 - 7:41and they let their children
escape challenging situations. -
7:42 - 7:44I want you to think about it like this:
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7:45 - 7:49Your child comes into the house
to you crying, in tears. -
7:49 - 7:51They're five or six years of age.
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7:51 - 7:54"Nobody at school likes me!
These kids are mean. -
7:54 - 7:56No one would play with me."
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7:57 - 8:00How do you feel seeing
your child so upset? -
8:01 - 8:02What do you do?
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8:03 - 8:08The natural parenting instinct
is to comfort that child, soothe them, -
8:08 - 8:11protect them and fix the situation.
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8:12 - 8:17Calling the teacher to intervene
or the other parents to arrange playdates, -
8:17 - 8:19that may be fine at age five.
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8:19 - 8:25But what do you do if your child
keeps coming home day after day in tears? -
8:25 - 8:30Do you still fix things for them
at age eight, 10, 14? -
8:31 - 8:33For children, as they are developing,
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8:33 - 8:37they invariably are going to be
encountering challenging situations: -
8:37 - 8:41sleepovers, oral reports,
-
8:41 - 8:43a challenging test that pops up,
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8:43 - 8:47trying out for a sports team
or a spot in the school play, -
8:47 - 8:49conflicts with peers ...
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8:50 - 8:53All these situations involve risk:
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8:53 - 8:56risk of not doing well,
not getting what they want, -
8:57 - 8:59risk of maybe making mistakes
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8:59 - 9:01or being embarrassed.
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9:02 - 9:04For kids with anxiety
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9:04 - 9:07who don't take risks and engage,
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9:08 - 9:12they then don't learn how to manage
these types of situations. -
9:12 - 9:13Right?
-
9:13 - 9:17Because skills develop
with exposure over time, -
9:17 - 9:22repeated exposure to everyday
situations that kids encounter: -
9:23 - 9:25self-soothing skills
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9:25 - 9:28or the ability to calm
oneself down when upset; -
9:29 - 9:30problem-solving skills,
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9:31 - 9:34including the ability
to resolve conflicts with others; -
9:35 - 9:37delay of gratification,
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9:37 - 9:39or the ability to keep your efforts going
-
9:39 - 9:42despite the fact that you have
to wait over time to see what happens. -
9:43 - 9:46These and many other skills
are developing in children -
9:46 - 9:49who take risks and engage.
-
9:49 - 9:52And self-efficacy takes shape,
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9:52 - 9:56which, simply put,
is the belief in oneself -
9:56 - 9:59that you can overcome
challenging situations. -
10:01 - 10:06For kids with anxiety
who escape and avoid these situations -
10:06 - 10:09and get other people to do them for them,
-
10:09 - 10:12they become more and more
anxious with time -
10:12 - 10:14while less confident in themselves.
-
10:15 - 10:19Contrary to their peers
who don't suffer with anxiety, -
10:19 - 10:24they come to believe that they are
incapable of managing these situations. -
10:25 - 10:29They think that they need someone,
someone like their parents, -
10:29 - 10:30to do things for them.
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10:32 - 10:38Now, while the natural parenting instinct
is to comfort and protect -
10:38 - 10:39and reassure kids,
-
10:40 - 10:44in 1930, the psychiatrist Alfred Adler
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10:44 - 10:47had already cautioned parents
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10:47 - 10:50that we can love a child
as much as we wish, -
10:50 - 10:52but we must not make that child dependent.
-
10:53 - 10:57He advised parents to begin training kids
from the very beginning -
10:57 - 10:59to stand on their own two feet.
-
11:00 - 11:04He also cautioned
that if children get the impression -
11:04 - 11:09that their parents have nothing better
to do than be at their beck and call, -
11:09 - 11:12they would gain a false idea of love.
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11:13 - 11:17For children with anxiety
in this day and age, -
11:17 - 11:20they are always calling their parents
-
11:20 - 11:24or texting distress calls
at all hours of the day and night. -
11:24 - 11:30So if children with anxiety don't learn
the proper coping mechanisms when young, -
11:30 - 11:32what happens to them when they grow up?
-
11:33 - 11:38I run groups for parents
of young adults with anxiety disorders. -
11:39 - 11:43These youth are between
the ages of 18 and 28. -
11:44 - 11:46They are mostly living at home,
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11:46 - 11:48dependent on their parents.
-
11:49 - 11:53Many of them may have
attended school and college. -
11:53 - 11:54Some have graduated.
-
11:55 - 11:58Almost all are not working,
-
11:58 - 12:00just staying at home
and not doing much of anything. -
12:01 - 12:04They don't have meaningful
relationships with others, -
12:04 - 12:07and they are very,
very dependent on their parents -
12:07 - 12:09to do all sort of things for them.
-
12:10 - 12:13Their parents still make
their doctors appointments for them. -
12:14 - 12:17They call the kids' old friends
and beg them to come visit. -
12:17 - 12:20They do the kids' laundry
and cook for them. -
12:20 - 12:24And they are in great conflict
with their young adult, -
12:24 - 12:28because the anxiety has flourished
but the youth has not. -
12:29 - 12:32These parents feel enormous guilt,
-
12:32 - 12:34but then resentment,
-
12:34 - 12:36and then more guilt.
-
12:37 - 12:39OK, how about some good news?
-
12:40 - 12:45If parents and key figures
in a child's life -
12:45 - 12:49can help the child, assist them
to confront their fears -
12:49 - 12:51and learn how to problem-solve,
-
12:51 - 12:54then it is more likely that the children
are going to develop -
12:54 - 12:58their own internal coping mechanisms
for managing their anxiety. -
13:00 - 13:04We teach parents now
to be mindful in the moment -
13:04 - 13:07and think about their reaction
to their child's anxiety. -
13:09 - 13:10We ask them,
-
13:10 - 13:14"Look at the situation and ask,
'What is this situation at hand? -
13:15 - 13:17How threatening is it to my child?
-
13:17 - 13:20And what do I ultimately
want them to learn from it?'" -
13:21 - 13:24Now of course, we want parents
to listen very carefully, -
13:24 - 13:28because if a child is being bullied
seriously or put in harm's way, -
13:28 - 13:29we want parents to intervene,
-
13:29 - 13:31absolutely.
-
13:32 - 13:36But in typical, everyday
anxiety-producing situations, -
13:36 - 13:38parents can be
most helpful to their child -
13:38 - 13:42if they remain calm
and matter-of-fact and warm, -
13:42 - 13:45if they validate the child's feelings
-
13:45 - 13:47but then help the child,
-
13:47 - 13:51assist them in planning how the child
is going to manage the situation. -
13:52 - 13:54And then -- this is key --
-
13:54 - 13:57to actually have the child
deal with the situation themselves. -
13:59 - 14:04Of course, it is heartbreaking
to watch a child suffer, -
14:04 - 14:07as my parents told me years later.
-
14:07 - 14:09When you see your child suffering
-
14:09 - 14:14but you think you could swoop in
and save them from the pain of it, -
14:14 - 14:16that's everything, right?
-
14:16 - 14:18That's what we want to do.
-
14:19 - 14:22But whether we are young or old,
-
14:22 - 14:27excessive anxiety leads us
to overestimate risk and distress -
14:27 - 14:30while underestimating our ability to cope.
-
14:32 - 14:37We know that repeated exposure
to what we fear weakens anxiety, -
14:37 - 14:40while building resources and resilience.
-
14:41 - 14:43My parents were on to something.
-
14:43 - 14:47Today's hyper-anxious youth
are not being helped -
14:47 - 14:49by overly protective parenting.
-
14:50 - 14:55Calmness and confidence
are not just emotions. -
14:55 - 14:59They are coping skills
that parents and children can learn. -
15:00 - 15:01Thank you.
-
15:01 - 15:04(Applause)
- Title:
- How to raise kids who can overcome anxiety
- Speaker:
- Anne Marie Albano
- Description:
-
Growing up means facing new challenges -- but for some kids, uncertain situations lead to anxiety that parents often seek to soothe. Psychologist Anne Marie Albano explains how constantly rushing to fix a child's problems can perpetuate a lifelong cycle of dependence and resentment -- and shares why a healthy dose of risk helps kids cultivate lasting confidence.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 15:19
Erin Gregory edited English subtitles for How to raise kids who can overcome anxiety | ||
Erin Gregory approved English subtitles for How to raise kids who can overcome anxiety | ||
Erin Gregory edited English subtitles for How to raise kids who can overcome anxiety | ||
Camille Martínez accepted English subtitles for How to raise kids who can overcome anxiety | ||
Camille Martínez edited English subtitles for How to raise kids who can overcome anxiety | ||
Camille Martínez edited English subtitles for How to raise kids who can overcome anxiety | ||
Joseph Geni edited English subtitles for How to raise kids who can overcome anxiety |