Areas › Worry and anxiety › Facing it a step at a time
Start with the body. Slow breathing, muscles let go one at a time, a piece of music, a familiar object in a pocket. Small levers, and they turn fear from something happening to you into something you are doing something about.
Children in particular notice the body first: the racing heart, the sick stomach, the tight chest. That is the part they are actually frightened of. Teach two or three things that reliably take the edge off, let them choose which ones they like, and let them use them before, during and afterwards. Nobody agrees to walk towards a fear with nothing in their hands.
Facing a fear in steps works, and it works best with someone guiding the ladder. Read this as an explanation of how it works, and take the steps themselves to a therapist.
Qur’an and Sunnah
Lord, lift up my heart (Quran 20:25). The first thing Moses asks for is his chest, before anything at all about the task.
قَالَ رَبِّ ٱشۡرَحۡ لِي صَدۡرِي
Moses said, ‘Lord, lift up my heart
Qur’an 20:25read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
In a randomised trial, eighty six people were assigned either an internet delivered treatment combining exposure and mindfulness or an online discussion forum, and the structured graded approach to feared bodily sensations and situations reduced symptoms. Working with the body directly can be part of a serious programme rather than a distraction from one. That trial was in irritable bowel syndrome, so the population is a long way from an anxious child.
Ljótsson B, Falk L, Vesterlund AW, Hedman E, Lindfors P, Rück C, Hursti T, Andréewitch S, Jansson L, Lindefors N, Andersson G. (2010). Internet-delivered exposure and mindfulness based therapy for irritable bowel syndrome--a randomized controlled trial.. Behaviour research and therapy doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Having something to do with the fear is what makes going near it agreeable at all.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Let the person facing it choose the first step, and let them choose an easy one. A rung somebody picked gets climbed. A rung assigned to them gets argued about.
Put a number on each step, nought to ten, and let it be your number. Two people facing the same school will not agree about which part is worst, and the ladder has to belong to the person climbing it.
Pick one picture and keep it. Shallow end, middle, deep end. Then the child, the parents and the school are all talking about the same thing without anybody needing the clinical words.