THE BLOG
01/30/2015 03:21 pm ET Updated Apr 01, 2015

How To Manage Your Anxiety About Your Kids

ARTPUPPY via Getty Images

Reader Anxious Mommy writes,

What are your recommendations for managing parental anxiety? I've always been a worrier, but having kids has taken my anxiety to a new level. Any minor incident can make my mind race, imagining the worst possible scenarios, often making it difficult to sleep.

This is compounded by the fact that my youngest has two serious medical conditions (severe asthma and food allergies) which have me on edge most of the time. I have difficulty relaxing when he is out of my care -- even if he is with someone I trust.

Generally, I would say that I have an overriding outlook that "The worst thing you can possibly imagine does actually happen sometimes." (Which is what happened when I was very young -- my father died, our house burned down on Christmas, and so on.

My anxiety definitely spills over into my interactions with my kids: "Don't climb too high! You could break your neck!" "Don't swing that stick! You could poke your brother's eye out!" "Don't take too big of bites! You'll choke to death!"

I'd like to be better about balancing my desire to keep them safe and healthy with the desire to let them be kids. What do you recommend?

Dear AM,

I empathize with you. I grew up in a highly anxious household and heard all those admonishments about potential danger and a lot more. Coupled with my sensitive temperament, this parenting style resulted in me being an extremely anxious child, with tendencies to ruminate about worst-case scenarios, obsessive-compulsive checking behaviors, social anxiety in public situations and concerns about health and safety. My anxiety interfered with sleep and gave me headaches and stomachaches. In my teens, I started to be very anxious about what I ate and about the idea of getting fat. I was also always worried about grades.  I didn't want A's, I just didn't want to fail, and I genuinely thought this was a possibility despite never getting less than A's (since I overprepared and overstudied so much). I was also very socially anxious, but tried hard not to seem this way, which was pretty stressful.

Throughout the course of college and grad school, my social anxiety abated slightly but my anxiety related to safety increased. After getting into a car accident when I was in my early 20's on I-95, I stopped driving on highways because of my fear of crashing. This phobia really bothered me because it limited me greatly in terms of where I could drive, and I was living in DC and going to grad school in College Park MD. To commute, I could only take routes with streets or else I would panic, and this made me feel pretty crappy about myself.

When I got married, the first thing I did was decide to treat my own highway driving anxiety with exposure therapy, e.g. doing it till I felt OK with it. My rationale was that there was no way in hell I was going to raise an anxious kid, so if I was married I had better start becoming less anxious, and quick. I was able to start driving again on highways with practice, although it was very hard. The next impetus I had to deal with my remaining anxiety was the birth of my oldest. From the time she was a baby, I knew she was wired like me (she is a Highly Sensitive Child) and this made it feel even more important that my behavior not change her sensitive temperament into a pathologically anxious one.

I resolved to show no anxiety around my kids, and you know what? I think I did pretty well with this. I really just stopped acting anxious around my kids, period. This got rid of most of my remaining anxiety internally as well. I made a point to approach other moms at parks, mom groups and even coffee shops so that my baby, and then toddler, would see that the world was filled with nice people just waiting to be friends with you. (As a child, I had been taught to be terrified of strangers and kidnappings.) I bit my tongue every time she fell or climbed high on the monkey bars. Eventually, I didn't have to bite my tongue anymore, I just genuinely didn't react when they moved close to the edge of the playground equipment or ate some mulch or were out of my sight for a minute at the park. Anyone who knows me in real life now can verify that I don't even know where the hell my kids are most of the time at playgrounds, and I am proud of this, because to me, it shows that I have both conquered my anxiety and showed my children that most of the time there is nothing to be worried about at all.

I would rather my kids have a shorter life with no worry than a longer life plagued by anxiety. And since you and I both know how destructive anxiety is, I hope you will see what I mean. But thankfully, I think that you can find a happy medium, especially regarding the life threatening allergy issue. Maybe you can say, I will do everything I can to prevent my child from his allergens, but I will stop short of appearing anxious or modifying my life dramatically. So, give the babysitter an Epi-Pen, but don't stop going out on dates with your husband. Give yourself the rule that if you have done what you can to prevent disaster, you must STOP ruminating and TRY YOUR HARDEST not to show anxiety to your kids.

Once you stop showing your anxiety, you will start to walk the walk, and feel less anxious internally. The mechanism for this is exposure, a behavioral term which means here that the more you see your kids doing "unsafe" things and living to tell about it, the less likely you are to feel anxious each subsequent time that you see this.

You can also use cognitive and mindfulness techniques to curb your anxiety, like de-fusing from your beliefs (seeing them as external to you; they reflect the product of an anxious mind, not reality), challenging your beliefs, re-framing, and replacing negative talk with positive or realistic talk.  And you want to stop suppressing or avoiding certain anxiety-producing thoughts, which I'll get to later.

Example: When you catch yourself thinking, Someone's going to give him nuts at the playdate and he's going to stop breathing and nobody will notice and he'll die, you say, in your mind, There goes my anxiety again. That anxious thought is a doozy (de-fusing). The likelihood of all those things happening, after I made sure to tell the other mom that he has a nut allergy, are almost infinitesimal (challenging, and realistic self-talk). The likelihood of him being angry as an adult if he never got to do a playdate as a kid because of my anxiety, on the other hand, is pretty high.

Another thing therapists do when treating anxious clients is creating an exposure hierarchy. This is where you write out all the anxiety-provoking situations you can think of and then rank them from easiest to hardest. This is about as much fun as it sounds. Anyway, you gradually force yourself to do these things, starting with the easiest.  Each time you're in the situation, you stay there till your anxiety peaks and decreases by half. So, you start out rating your anxiety 1-10, with 10 as the worst. Then, you stay in the situation till, let's say, an initial rating of 10 goes down to a 5.

Anxiety is like a bell curve, peaking and decreasing over a matter of minutes, but people don't realize this, because they usually don't stay in anxiety-provoking situations long enough to see that eventually, their anxiety will go down. You can get used to anything, which incidentally relates to my idea of monotogamy (aka getting used to sex with your husband and not getting excited anymore).

So, here is an example of an exposure hierarchy, and note, it includes thoughts as well, because there are thoughts that make us anxious, so we push them out of consciousness, where they simmer and percolate and make us more anxious in the long run.

10. Letting my kid stay with a babysitter who has never used an EpiPen

9. Letting my kid help me chop vegetables for dinner

8. Trusting a friend to take my kids to the swimming pool without me

7. Not cutting my kids' food up into tiny bites

6. Thinking about someone not knowing how to work an EpiPen

5. Thinking about my child in anaphylactic shock

4. Letting my husband watch the kids without calling and checking on them every hour

3. Watching my kid climb high on the playground and not standing right there

2. Thinking about my kid going to preschool and someone giving him nuts

1. Talking about my kid's nut allergy to my anxious mom

So, you start with #1, and you talk to your mom about your kid's nut allergy, even though she makes everything worse with her anxiety. You start the conversation and in your mind, ask yourself what your rating is. Probably since this is your easiest thing, your anxiety won't hit a 10, but maybe a 6 or 7.  So then you talk to her for minute after minute, until your anxiety goes down by half to a 3 or 4, and mostly you feel boredom and annoyance. This should probably take about 20 minutes.  The minute your anxiety decreases by half, you're done and you can move on the next day to the next thing on your hierarchy. If you're still anxious by the end of an hour talking to your mom, just try it again the next day till your anxiety goes down by half during some reasonable amount of time. Once this is accomplished, bam, now you don't have to be scared of the phone ringing when it's your mom.

So how does exposure work for anxious thoughts? Let's use the example, "Thinking of your kid in anaphylactic shock." It's simple: you literally sit there and picture your kid in anaphylactic shock. This is not morbid, it is THE ONLY WAY to stop fearing this thought. Obviously, if you saw your kid in anaphylactic shock, you would be scared and upset, and would urgently mobilize to help him, but the THOUGHT is different than the EVENT. Right now, if you're like a majority of anxiety sufferers, you push this THOUGHT out of consciousness because you "can't handle even thinking about it," which is called avoidance. When you avoid or suppress a thought, it pops up even more, like if I tell you, "Don't think of a white elephant!"

So, instead, when you have one of these scary thoughts, you must sit with the thought until your anxiety peaks and decreases. As crazy as it may sound to you right now, the goal is to get to a place emotionally and psychologically where the idea of your kid in anaphylactic shock does not make you anxious. And that's great, because it's a thought. It's not the actual experience. (Find an analogous thought of your own that doesn't make you anxious but might make other people anxious to understand what I mean. Your husband cheating? Your boss getting mad? Gaining five pounds? Misplacing your wallet? Odds are, at least one of these is an anxiety-free thought to you; you'd be anxious in the situation but the thought itself doesn't cause you a physical anxiety response. So we want the anaphylactic shock thought to be like this.)  Seeing your child in anaphylactic shock will always make you upset, and will mobilize you to call 911, use the EpiPen, and so forth, but if the THOUGHT of it comes into your head, you will feel nothing, which is the best outcome, since this thought does not mean your kid is in anaphylactic shock!  By the way, I used the phrase "anaphylactic shock" as much as I could in this paragraph, because even reading it over and over is a form of exposure.  Free exposure therapy!  Read it over and over until you feel nothing at all except annoyance that you're wasting your precious time away from the kids not doing anything relaxing but rather just reading this post over and over.

I hope this post has given you some things to think about, and even to try.  If my tips don't work for you, please seek help from a therapist who specializes in anxiety, and consider medication management as well.  Good luck and I commend you for trying to moderate your anxiety for yourself and for your kids.  Every anxious mom should follow your example.

Till we meet again, I remain, The Blogapist Who Has A Kid With An Egg Allergy So I Feel Your Pain, Even Though He's Never Been In, Say It With Me, ANAPHYLACTIC SHOCK.

Dr. Rodman blogs at Dr. Psych Mom, and visit her on Facebook and Twitter @DrPsychMom too.