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Anxiety

My Child is Having a Panic Attack

The principles of nonviolent resistance hold promise to reduce escalation.

George Grie/Wikimedia
Source: George Grie/Wikimedia

My child is having a panic attack. Or maybe it is not quite a panic attack as defined by the DSM-5 (Diagnostic and Statistical Manual of the American Psychiatric Association, 5th edition) but more like emotional flooding, a drowning in exaggerated negative feelings. Some of these reactions are of panic, but they also include biased thoughts of personalization (“It’s all my fault”), overgeneralization (“I’ll never be able to….”), and much self-loathing (“I’m a loser.”) She phones me 10 times over and over, though her cell phone battery is running out of juice. I tell her she needs to stop calling in case I can’t find her where she’s waiting in the city. After we are both safely home, I feel exhausted and incompetent. My family thinks they understand, but they don’t really, because they do not receive these hysterical phone calls, the welling up of extreme, irrational emotions and temporary loss of rational thought. Though my child and I talk about the incident the next day, and I think we have each learned better ways of coping with the triggers, a few weeks later the phone calling, the emotional flooding, reoccurs.

So how can we help our loved ones deal with these incidences of such overwhelming emotion? Fear and anxiety are part of most children’s and adolescents’ lives, and emotional flooding is not infrequent in children and young adults with ADHD and other mental disorders such as bipolar disorder. One practice I am considering is that of nonviolent resistance (NVR), a systematic approach for helping parents, teachers, and other caregivers cope with children’s violent and self-harmful behaviors by utilizing only nonviolent and non-escalating means (Omer, 2004). As Haim Omer and Eli Lebowitz recently explained in the Journal of Marital and Family Therapy, NVR entails five treatment steps. The step that seems most relevant and promising as a way to help our children cope with emotional flooding and panic attacks is called “antiescalation training,” for which the authors have created three catchphrases.

First, “strike the iron, when it is cold!” In other words, parents need to overcome the urge to immediately respond to the child’s behaviors. The reason is that we want to avoid acting when we are most aroused (and irrational ourselves). Instead we help ourselves and model for our children taking, literally, a breather, a pause. In particular, Omer and Leibowitz recommend that we learn to take an actual deep breath, delay the temptation for immediate (re)action, and develop a plan.
Second, “you can’t control the child, but only yourselves!” This phrase aims to replace parents’ impulses to control the child by modulating one’s own emotions and not losing one’s own “cool” rather than mirroring them, which is more automatic.

Lastly, “you don’t have to win, but only to persist!” Parents are encouraged to change the time span of “this must be fixed now” to a longer time span that considers interactions and incidents over days, weeks, and, even, months.

But buyer beware: NVR is a relatively new approach for helping caregivers reduce children’s aggressive behaviors; its application to other problems has not been thoroughly studied. Many studies have found that the most effective evidence-based treatment for children and adolescents with flooding’s closest cousin, anxiety, is the combination of cognitive behavioral therapy and medication, particularly SSRIs (selective serotonin reuptake inhibitors, such as Prozac and Zoloft). However, 20 percent of children with anxiety do not respond to those two therapies. Even for those that do, it seems essential for parents and other caregivers to have additional “tricks” in their bag, especially those with no cost or side effects. NVR will be one method that I will try.

References

Omer, H. (2004). Nonviolent resistance: A new approach to violent and self-destructive children. New York: Cambridge University Press.

Omer, H., & Lebowitz, E. R. (2016). Nonviolent resistance: Helping caregivers reduce problematic behaviors in children and adolescents. Journal of Marital and Family Therapy, 42, 688-700.

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