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I have read many books, attended many classes, and watched many videos explaining the theories and techniques of cognitive behavior therapy. My favorite video, though, was not produced by a mental health professional, but by the television network, Nickleodeon.
Rugrats aired from 1991 through 2004. The show addressed common childhood experiences through humor and understanding.
In Chuckie and the slide, the ever-fretful Chuckie Finster longs to go down the slide and have fun like all the other kids at the park. But when he looks up, the slide appears menacing. His perpetual nemesis, Angelica, makes fun of him and calls him a "scaredy cat." Fortunately, Chuckie has a good friend in Tommy Pickles. Tommy takes Chuckie to the smartest kid on the block, Suzie, who agrees to help.
Under Suzie's guidance, the neighborhood kids help Chuckie face his fears by gradually exposing him to heights, to going back and forth in a tire swing, having a fan blowing hard in his face, and traveling fast in a wagon. As he get used to the physical sensations connected to heights and moving at a high rate of speed, Suzie instructs him to tell himself repeatedly, "I'm a big brave dog!"
These are some of the basic strategies of cognitive behavior therapy--exposure to the feared situations and learning more adaptive ways of thinking.
The simple charm of Rugrats is that it teaches its lessons with humor, yet never minimizes or ridicules Chuckie's fears. The fears are portrayed as common.
Of course, the episode ends with Chuckie triumphantly climbing up the slide and enjoying the trip back down. When the other kids ask how he overcame his fears, he answers: "I just did. That's all."
Chuckie had help, but the success was all his own.
Believe it or not, I once worked with an 8-year-old girl who had the same fear as Chuckie. She felt ostracized by other kids at recess because she was too fearful to join them going down the slide on the playground. I helped her by using Chuckie's basic principles of CBT:
- Don't do too much too soon. Behavior therapy works through "exposure" and "habituation." By gradually being exposed to mildly anxiety producing situations, the child adapts to the experience and anxiety decreases (this is called habituation). However, if the situation is too overwhelming, the child may feel more fearful and discouraged. Taking some time helps the child develop more confidence. The little girl I worked with expressed a willingness to climb up two rungs of the ladder on the slide after one session, and more rungs after subsequent sessions. I encouraged her, but it was always her choice how far to go.
- Make it a habit. Exposure to the anxiety-producing stimulus needs to be frequent. She agreed to climb to the agreed-upon height every day after school with a parent present.
- Exposures should be prolonged. She would stay on that rung until she felt comfortable--the anxiety was no longer ruling her behavior. She was learning that the anxiety can go away and the fear became less powerful. On the other hand, if she were to leave the situation while her anxiety was high, this would only reinforce her escape or avoidance behavior.
- Self-statements are important. Kids, just like adults, have thoughts that can maintain their anxiety. The more this girl thought that she couldn't do something, the more she felt the need to avoid that situation. While positive self-talk alone does not take anxiety away, realistic thinking allows the child to cope more effectively. What self-statements did this slide-fearing little girl use to increase her confidence? "I'm a big brave dog," of course.
Copyright 2011 Greg Markway, Ph.D.
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