Separation anxiety
Separation anxiety is the most common anxiety condition in children under 11. Image Credit: Shutterstock

As a kid, one of your greatest fears is having your parent ‘stolen’ from you, whether because of a person or situation – it can cause a lot of anxiety. If you find your child lashing out, crying or behaving in an unusual manner when you are parted, it could be a case of separation anxiety.

“Separation anxiety can be a normal part of early-childhood development. It is a fear of separation from an ‘attachment figure’, usually their mother, but also frequently both mothers and fathers,” explains Dr Waleed Ahmed, Consultant Psychiatrist at UAE-based Priory Wellbeing Centre.

Fortunately this state is usually temporary and requires – generally – you to just be patient. It’s only if the anxiousness starts to interfere with daily activities and other aspects of development, it is then considered a disorder that reflects pathology, he explains.

What’s the typical age when this sort of anxiety sets in?

In toddlerhood, when you are the centre of the child’s world. “Separation anxiety is the most common anxiety condition in children under 11. It can present at any time throu ghout childhood, although typically not above the age of 14,” says Ross Addison, Managing Director and Consultant Child and Adolescent Cognitive Behavioural Therapist at UAE-based Reverse Psychology.

Why does it happen?

The trigger for the emotional disturbance could be manifold. Addison says: “It is triggered by a perceived threat the child experiences when faced with concerns relating to safety and security of self, or loved ones. Therefore, a single event, or multiple events could lead a child to experience separation anxiety.

“It does not only develop through separations, but often can present if self or a loved one has been sick or developed an illness, been involved in a car accident, parents have separated or divorced, or if a child hears of any threatening incidents a child has experienced.”

Media can play a role in the onset of this fear as well. “I quite often have worked with children who have also developed separation anxiety through urban myths on YouTube or watching scary movies,” explains Addison.

Dr Ahmed points to a temperamental predisposition. “Temperamental or personality factors that are evident by an early history of anxious behaviours and traits – this may indicate a genetic risk.”

Finally, it may be the way a parent is raising the child. “Parenting and parental beliefs projected early on can lead to the child struggling to gain autonomy and achieving the developmental task of coping with separation – one is likely to see anxiety disorders or an anxious personality in parents if this is the case,” he adds.

Signs of separation anxiety

While a child may not offer up overt displays of unease, he or she may employ a number of tactics to stay with a parent or guardian who they are scared of losing. These include:

Avoidance behaviours: “Typically, the child avoids activities that require normal separation from caregivers such as play dates, birthday parties, day trips, etc.,” says Dr Ahmed, adding, “If this happens in the context of school, it can lead to school refusal.”

Defiance: “Many children display oppositional and defiant behaviours on separation,” adds.

Situational behaviour: “One can have a situation when a child may happily separate from parents for school but may struggle when that happens in attending a social gathering. Less often, separation anxiety can be episodic,” says Dr Ahmed.

Coping with separation

It’s a daunting proposition for any parent to walk away (even temporarily) from their child, especially when they can see the kid struggling. But there are some measures that would make that move easier.

1. Employing Cognitive Behavioural Therapy (CBT): “Within CBT, we would apply a technique called Exposure Therapy, which involves gradually supporting your child to come closer to their fears, to help demonstrate to them that their worry does not come true,” says Addison.

What would you do: First, set up experiments after identifying the actions that carry the most anxiety. “It may mean setting up experiments, having identified the situations that make your child worry (going to the bathroom alone, being in their bedroom at night time alone, the child being left with the nanny, being in bed alone ... whatever the fearful situations are).

“It's a good idea to start with the least worrying experiments first as this will help build their confidence and provide evidence to them that they do not need to worry,’ says Addison.

Do short experiments and slowly widen the window of experience. “For instance, start with just a few seconds alone in their bedroom, gradually increasing the time as their confidence improves. The setting of experiments based on difficulty is known as establishing a Graded Hierarchy,” he adds.

2. Establish some self-talk routines: Use fact-based statements to reassure your child and have them say them out aloud so that they can self-soothe. “Some general examples may be, 'Mum has always come home', 'Nothing bad has ever happened to us at home', 'Mum and dad are just in their bedroom next door' and 'I can call out to mum or dad if I need them'. The self-talk phrases should be specific to your child and work to reassure them on the identified worries that they have,” he says.

3. Support, don’t scold: “Be patient, your child is worrying and will benefit more from support rather than a tough approach,” he adds.

4. Positive reinforcement can really help: “Sleep with a lamp on, perhaps with the bedroom doors open. After they've got into bed, come and check on them after 10 minutes. After each successful experiment offer a lot of praise. If unsuccessful, praise the effort and try an easier experiment,” he suggests.

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