The Science of ACEs

The CDC-Kaiser ACE Study, conducted between...was the first to examine the relationship between early childhood adversity and negative lifelong health effects. The research found that the long-term impact of ACEs determined future health risks, chronic disease, and premature death. Individuals who had experienced multiple ACEs also faced higher risks of depression, addiction, obesity, attempted suicide, mental health disorders, and other health concerns. It also revealed that ACEs were surprisingly common—almost two-thirds of respondents, part of the largely white, well-off sample, reported at least one ACE19.

For infants and toddlers who are exposed to persistent stress, these kinds of adverse childhood experiences can cause changes in brain structure, potentially harming their physical, emotional, and educational development far into the future.

Yet ACEs are not inevitable, nor do they have to determine the destiny of a child who experiences them. ACEs can be prevented, and when they do occur, concrete steps can be taken to help children heal...supportive relationships, can serve as a protective buffer, and help children foster resilience and thrive.

hyper-awareness

 

:Jon Hershfield, MFT

"Once you understand Hyperawareness Obsessions and how the mind has gotten stuck, you can learn to stop doing what makes sense instinctively (the mental equivalent of flailing about in quicksand) and do the mindfulness and CBT work that can help you get grounded again.

Your whole life, you were one way and now you appear to be another. This statement represents one of OCD’s cruelest, and frankly, laziest efforts to dominate your attention. Once it gets you to sign the contract, that you will commit to being unhappy so long as you are this way now and not the other way as before, you remain its slave. Hyperawareness or sensorimotor obsessions are characterized by an excessive concern that your attention to some otherwise forgettable or involuntary bodily process will become totally and permanently conscious. In other words, we do a lot without thinking about it, so thinking about it feels uncomfortable. Here are some examples of common experiences people with hyperawareness obsessions struggle with:

• Blinking
• Swallowing
• Breathing
• Heartbeat
• Hunger levels
• Itches or minor pains
• Hair touching forehead, ears, or neck
• Positioning of body parts (i.e. where the arms are in relation to the rest of the body, where the tongue rests in the mouth)
• Items in the field of vision (e.g. the nose, eye floaters)
• White noise (e.g. the hum of a refrigerator)
• The very presence of thinking taking place

Like any obsession, there is a fair amount of cross-over into other obsessions. Hyperawareness of sensations in the hands, for example, can be triggers for obsessive fears of harming self or others. The focus of this blog is primarily on the obsessive concern with the awareness itself.

What Are You Actually Afraid of?

In some cases, it may appear that you are simply over-sensitive or have a low tolerance for specific discomforts, but in this form of OCD the problem is that the mind has become overly attached to a specific target and simply stuck there. Efforts to detach the mind from its target seem to have the opposite effect. Why this? You may wonder. In most cases, OCD gets you stuck on unwanted thoughts that are inherently disturbing (e.g. about illness or unwanted sexual or violent thoughts). People who suffer with those types of obsessions don’t want to be stuck there either, but with a sense of purpose. Who would anyone want to think such terrible things? What makes hyperawareness obsessions all the more frustrating is that the person experiencing the obsession is not only stuck, but feels stuck as if with no sense of purpose. Why am I thinking about my breathing instead of just breathing without thinking about it? However, it is not really the case that hyperawareness obsessions have no underlying fears. The seemingly innocuous obsession with unwanted awareness is just the surface of often much darker concerns. Some related obsessive thoughts include:

• I will be permanently distracted by these thoughts
• I will never feel what it felt like to experience this automatically, without conscious attention
• I will be depressed forever because this thought will dominate my attention during meaningful experiences (e.g. my wedding and memories thereof will be ruined by my focusing on my blinking)
• I will embarrass myself socially because I can’t pay attention to anything but these thoughts
• I will have a mental breakdown, a panic attack, or become psychotic because of constantly thinking about this

More Compulsions Than You’d Think

People with these types of obsessions often assume that they are not...compulsions because the experience is mostly one of lamenting the intrusive thoughts. I wish I wasn’t thinking about this! But actually, many compulsions drive these types of obsessions and being able to identify and resist or interfere with them is key to overcoming this issue. Here are a few examples:

• Mental checking to see if awareness is still present
• Mental or physical checking to see if the sensation feels “normal”
• Repeating the activities (e.g. blinking, swallowing, checking, etc.) a specific number of times or in a ritualistic way to give oneself permission to stop thinking about it
• Relying heavily on distraction to avoid having the thoughts
• Reassurance seeking that the awareness will go away or that it’s normal to be aware
• Mentally reviewing how it must have felt before hyperawareness set in
• Avoidance of environments or circumstances where awareness might become more pronounced
• Mental rituals (e.g. chants, affirmations, neutralizing statements, etc.) to neutralize the fear of being permanently aware

 

Cognitive Behavioral Therapy (CBT) and Hyperawareness

At the core of these types of obsessions is the problem of over-protecting the present moment. It is what it is, but you’re concerned about ruining it. The idea is that if I am thinking about an involuntary or inconsequential process, then by definition, I probably should be thinking about something else. Thinking about the last time I blinked or the next time that I will is the same as squandering attention that could have been placed somewhere more fulfilling or useful (anywhere). Cognitive therapy asks that you take these thoughts and challenge their assumptions. For example, “I should not be aware of this” can be challenged as “I can’t control what’s on my mind and I don’t need more rules.”

Though “should” thoughts take center stage with hyperawareness, other common cognitive distortions can be recognized as well. Catastrophizing, for example, can come in the form of “If I don’t stop thinking about this my life will be destroyed.” Magnifying (relating to the thoughts or feelings like they’re a bigger concern than they are) also plays a serious role. Here, a thought like, “Oh, no, I’m thinking about my breathing” can be challenged as “Right, so I think about my breathing. Breathing happens.”

Efforts to bring the way you perceive the problem back to an objective viewpoint can help reduce the intensity with which you may feel you have to get rid of the problem. The problem is, after all, not the problem it appears to be. OCD will tell you that the problem is you can’t stop thinking about your awareness. But the actual problem is that you are trying to control your mind. Loosening this control effort opens you up to accept uncertainty and expose to your fear that the uncontrolled mind will contaminate your life.

Exposure and Response Prevention (ERP) and Hyperawareness

Like exposure and response prevention (ERP) for other forms of OCD, much of it comes down to doing willingly what your mind is doing against your wishes (exposure) and then resisting the urge to flee from the resulting discomfort (response prevention). Compulsive efforts to stop thinking about the obsession only seem to teach the brain that there is something special or interesting about the subject. Instead ERP aims to change the relationship between you and the fact that this thinking is occurring in this way. ERP for hyperawareness obsessions may typically come in the following four forms:

• Setting up reminders to bring your attention to the target of your obsession on purpose

Like a lot of ERP, this may seem counterintuitive or redundant. After all, you’re already spending a lot of time frustratingly noticing the things you don’t want to notice. However, your experience is almost exclusively on the defensive. The thoughts are intruding and you are trying to keep your cool, trying to make it stop, trying to distract. Lots of trying. By purposely bringing the thought to mind, you take an assertive stance and that means you are approaching ERP from the angle of practicing the work, not trying to avoid it. If the fear is obsessing forever, then trying to obsess denies the OCD its power position. Learning to let go of resistance to the idea that you may obsess forever is the best way to get to the other side and discover that this experience, like all others, is also impermanent.

• Writing scripts describing the consequences of being permanently aware

Imaginal exposures can be very effective in treating OCD, particularly if the feared outcome is undiscoverable until death. You won’t know if your life has been totally annihilated by your obsession until your life is, well, over. So, taking the mind on a fictional journey through a life consumed by your obsession can effectively generate the sense of uncertainty and the emotional terror that comes with it. In a script like this, you could describe what you think it would really be like if this state of hyperawareness was a permanent upgrade to your operating system. The purpose of this exercise is to generate the urge to do compulsions so you can learn to be in the presence of this urge and not give in to it. Through this practice, you also learn to accept uncertainty because you do not automatically get thrown by your uncomfortable feelings.

• Agreeing with thoughts about permanent awareness

Taking the software upgrade metaphor further, agreeing with your unwanted thoughts about awareness in the moment is also an excellent strategy for breaking down the resistance that keeps the obsession alive. The OCD may say “You’re thinking about swallowing again and it’s going to take over your life!” You say, “You bet. The old version of me was relatively unaware of when or why I swallowed and how it felt, but Me 2.0 is always aware.” This approach takes the wind out of OCD’s sails and leaves it with little else to threaten you.

• Putting yourself in likely triggering situations

Instead of trying to get to a distracted place where you feel free of your hyperawareness triggers, you can expose yourself to environments where triggers are likely to come up. One way to do this may be to consider what things you have already been avoiding. For example, engaging in social behavior can be an exposure if you have hyperawareness obsessions about eye contact.

Mindfulness and Hyperawareness

The whole purpose of mindfulness is to increase your awareness of what the mind is doing in the present moment, so it may seem counterintuitive to use mindfulness as a part of treatment for hyperawareness OCD. But this concern reveals the actual problem with hyperawareness obsessions. You are aware that the mind is attending to something, so in a sense you are being mindful there, but you are missing the opportunity to also be mindful of the resistance to that attention. Instead of noticing the resistance as simply another object of attention, you are identifying with the resistance, which is feeding the OCD. In other words, the wish that you not think about [insert target here] is also something to be mindful of. In meditation practice, you can learn to identify resistance as an object of attention and notice when you are trying not to think something when it would be more skillful to simply observe that thinking is present. When you let go of the drive to stop thinking about your awareness, you may feel discomfort, a sense that the walls are closing in or your time is running out somehow. This discomfort is a feeling and, thus, subject to the same rules as any other object of attention.

People with hyperawareness or sensorimotor obsessions may feel isolated from the rest of the OCD community. It is easy to make the mistake of thinking that it isn’t OCD because the compulsions are not so visible or the subject matter is not so content-focused. But once you understand how the mind has gotten stuck, you can learn to stop doing what makes sense instinctively (the mental equivalent of flailing about in quicksand) and do the mindfulness and CBT work that can help you get grounded again".

Herman

"Under ordinary conditions of peace, I would suggest that shame is one of the primary regulators of social relations. Fear is the primary regulator only in circumstances where social structures for maintaining peace have broken down and social relations are ruled by violence''.

Judith Herman

"Hennighausen and Lyons-Ruth(2005) propose that as humans have evolved “from biologic to dialogic” relational modes, the attachment system has been “partially displaced from its primate base”. Emotional sharing and signalling become the primary mode for regulating security of attachment. The infant preferentially seeks out the care-giver who best knows her mind and is most attuned to her emotional signals. She also learns to imagine how others think of her, to become self-conscious.

The child learns that shame states do not signify complete disruption of attachment bonds and that they can be regulated. Through repeated experiences of this kind, the child and care-taker learn to negotiate emotional attunement and mutuality in their relationship. Where no corrective relational process takes place, pathological variations in the attachment system can develop. In particular, we see disorganized attachment where the primary attachment figure is a source of fear. I would argue that we also see disorganized attachment where the primary attachment figure is a source of unremitting shame. In this case, the child is torn between need for emotional attunement and fear of rejection or ridicule. She forms an internal working model of relationship in which her basic needs are inherently shameful''.

Judith Herman

"To hold traumatic reality in consciousness requires a social context that affirms and protects the victim and that joins the victim and witness in a common alliance. For the individual victim, this social context is created by relationships...For the larger society, the social context is created by political movements that give voice to the disempowered''.

Judith Herman

It's nothing personal

"What was interesting and often overlooked by those studying the results of the Milgram experiments was that those who were more likely to refuse to carry out orders they were led to believe caused pain and suffering were from 'lower socio-economic groups'...Managers and professionals on the whole carried out the instructions with fewer qualms. Ergo they find cruelty and oppression easier to rationalise and accept''.

"Those who don't study history are doomed to repeat it. Yet those who do study history are doomed to stand by helplessly while everyone else repeats it."

"The point Habermas makes is that many (most?) of the collective actions that we undertake in our work lives are not communicative because they are aimed at achieving a particular outcome regardless of whether or not there is any shared understanding about the objective or the means by which it should be achieved. Habermas terms such actions strategic. To sum up: actions that are carried out in the professional sphere are invariably strategic, whereas those that are performed in the social/personal sphere can be communicative".

"As Alvesson and Willmott state in their book:

Within the rationality of the system individuals are treated as numbers or categories (e.g. grades of employees determined by qualifications, or types of clients determined by market segments), and more generally as objects whose value lies in reproducing the system."

"However, the instrumental logic of the system – i.e. the logic which “justifies” the manipulation of individuals – is ultimately self-defeating. As Alvesson and Willmott note:

The devaluation of lifeworld properties is perverse because the instrumental rationality of the system depends on the communicative rationality of the lifeworld, even though it appears to function independently of lifeworld understandings and competences. At the very least, the system depends upon human beings who are capable of communicating effectively and who are not manipulated and demoralized to the point of being incapable of cooperation and productivity".

Dr. Robert Sapolsky: The basic theme is that we are biological creatures, which shouldn't be earth-shattering. And thus all of our behavior is a product of our biology, which also shouldn't be earth-shattering—even though it's news to some people.

If we want to make sense of our behavior—all the best, worst, and everything in between—we're not going to get anywhere if we think it can all be explained with one thing, whether it's one part of the brain, one childhood experience, one hormone, one gene, or anything. Instead, a behavior is the outcome of everything from neurobiology one second before the action, to evolutionary pressure dating back millions of years.

Your book expresses some pretty novel ideas about free will and the criminal justice system.
I do not believe in the existence of free will, but it's incredibly difficult to imagine a world in which people have accepted that reality, particularly when it comes to the criminal justice system. Ultimately, words like "punishment," "justice," "free will," "evil," "the soul," are utterly irrelevant and scientifically obsolete in terms of understanding our behavior. It's insanely difficult for people to accept the extent to which we are biological organisms without agency.

This matters more in some areas than in others, right?
If someone compliments you on your hairstyle, and you want to take credit for it instead of outlining the millions of years of force that drove you to choose that style over another, that's not a big deal. But where we have to get away from absurd, outdated ideas about our own agency and think through the biology are the realms of behavior that we judge harshly: when sitting on a jury, when evaluating a student in a classroom, when trying to make sense of a loved one's behavior… That's where we need to acknowledge that it's just biology every step of the way.

You open the book confessing that you have a fantasy of enacting justice against Hitler, even though that fantasy contradicts your scientific perspective concerning justice against evil. It sounds like you're suggesting that we should have empathy for those who commit the worst crimes, even if it goes against our impulses.
The analogy I always use, which is so difficult for people to swallow when it comes to the criminal justice system, is that if a car has faulty brakes, you fix the breaks. If the brakes are not fixable, you put the car in the garage for the rest of the time, and your primary responsibility is to make sure this car with the faulty brakes doesn't hurt anybody. But nobody is saying you're punishing the car. Nobody is accusing your car of having a moral failing. Somehow, we have to reach that mindset.

Most people would react with hostility to this way of thinking, since it is so different from how we look at things today.
This shift in thinking sounds inconceivable to people in most realms, but we have done it in the past. Five hundred years ago, if you were a smart, thoughtful, reflective, even bleeding-heart liberal, you still believed that anyone who had a seizure was demon-possessed, and therefore you should burn them at the stake. It took us those 500 years to develop a mechanized view of epilepsy, thinking of it like a car with broken brakes, realizing, "Oh, it's not this person's fault, it's not a problem with their soul, they didn't have sex with Satan, they have little feedback loops in their brain. Since it's taken Western civilization 500 years to get there with seizures, who knows how long it will take us to do it in the more subtle realms of abnormal behavior that we currently explain with theology.

If we aren't responsible for our bad behavior, then we're also not responsible for our good behavior, right? Would that mean that all success in life is by chance?
That one's the sleeper in the equation. As difficult as it is for us to be comfortable with a mechanized view of our worst behavior, it's much harder for people to accept that it's all biology when it comes to our good behavior as well. It's a less pressing problem compared to issues of mass incarceration. But yes, we need to acknowledge how much sheer damn luck of biology has gifted some of us with things that others haven't.

Abolishing the notion of free will also contradicts the Abrahamic theology of God's relationship with man—and perhaps the existence of God altogether.
It is in passing...But it is also an attack on something else: The idea that we are more than our brains, that there's something inside of us, a being that is in our brain but not of our brain, a "me" that is more than just biology. And that is as grounded in reality as alchemy or astrology. Some people tie that idea into a religious framework, but even outside of religion, your average person believes that there's something more to themselves than just chemistry or biology.

So your theory goes beyond religion or the the soul. You are attacking our fundamental understanding of human existence.
Every other year I teach a classroom version of the ideas in this book. There will be around 500 or 600 people in there, and so it's statistically guaranteed that I'll have five or six students having a religious crisis over all of this, and three or four others having some kind of existential crisis. It's very unsettling stuff. We like our individuality, we like the mysteriousness of us, the essentialism of us, and it can be alarming to see the biological gears turning underneath.

Can this understanding help us predict behavior?
There's not a whole lot of science that can look at a group of people with damage to their prefrontal cortex and say "this one is going to be a serial murderer, and that one is going to belch loudly at a eulogy and not understand why it's socially inappropriate." But when you look at the pace of what we're learning about the origins of human behavior, in time the notion of that little being that sits inside our brains making decisions is going to get crowded into smaller and smaller places.

One non-biological factor that you believe influences our behavior is culture. Or does culture impact the biology of our brains, too?

It does in enormous ways. If you were raised in hard-assed individualist United States versus East Asia's collectivist culture, that may produce different ideas about cooperation and how you interact with a crowd. Take someone who was raised in an urban environment of more than 100,000 people, versus someone who was raised in a rural area. On average, those raised in an urban environment have a larger amygdala [a region of the brain involved with fear and anxiety]. So in that way, culture can physically change the brain.

What if you're from the rural South?
There's a famous study where student volunteers thought they were involved in a study surrounding their math abilities, but the experiment actually occurred outside in the hallway. Some beefy guy walking the opposite way bumps into a student as he walks past, then says, "Watch it, asshole," before marching away. When the student comes in to take the math test, the researchers take their blood pressure, check their hormones. And if you're from the American South, your blood pressure will be higher, and you'll be more stressed out. This impacts your judgement and how you respond to a given situation.

This is because, by best evidence, the American South was settled by herders and pastoralists from northern England and Scotland, who had a culture of honor. Centuries later, there's still a residue of that. So this makes culture not such an intangible factor of brain development and behavior. Within minutes of birth, this kind of training starts.

Can understanding these factors get us closer to having free will?
If you were brought up in a culture that values reflection, introspection, and critical thinking about your own thinking, one that questions whether you are being rational or if you are rationalizing, then you're training your cortex to be a better assessor of what's going on in your limbic system [a region of the brain that influences behavior, but isn't engaged in conscious thought]. When you're being asked to think about the meaning of your intuitions before you act on them, maybe along the way you decide your intuitions are destructive or make no sense at all. And then you don't act on them.

Stern on anxiety

I am your anxious and panicked kid, all grown up, and I’d like to tell you a few things you may not know about your child.

You may find yourself with a child you believe is acting out; purposefully trying to be difficult, and for no reason. You have tried everything and you’re at your wit’s end, which means now you’re yelling when you don’t want or mean to do so.

Your child keeps complaining they can’t sleep when they haven’t even tried. They’re having tantrums over smaller and smaller things; melting down faster than ever. They keep losing or misplacing valuable things, they seem to purposefully forget how to help around the house, or refuse to come out of their room.

Let me explain what is happening to your anxious child.

The most important thing to know is that your child is not actually “acting out” or “being difficult for no reason.” There is ALWAYS a reason that kids melt down or have tantrums.

Try to describe, out loud to someone you know, the feeling of complete and utter frustration. Here’s the catch: You can only use the limited vocabulary of a 6-year-old.

Hard, right?

Kids don’t have the words to describe how they feel—hell, adults can barely do it, why do we think kids can? When you don’t have a language that articulates the exact sensations you’re experiencing, your already-large emotions become even more exacerbated.

There’s a battle that exists in the space between experiencing a bad feeling and not being able to articulate the bad feeling. And it’s in this space that anxious kids fall and melt down.

This is going to sound odd, but your anxious child doesn’t know how to “try to sleep.” Not without some help. What they are looking for is comfort and soothing. The transition from day to night, from awake to asleep, from loud to quiet, is acutely difficult for anxious people. Transitions are uncertain and scary.

An anxious kid needs help down-regulating. Anxious kids need to be taught how to self-soothe in ways that are healthy. That’s what you’re there for—to walk them through. To set up routines you’ll help your kids implement and stick to.

Anxious kids need more help than your non-anxious children. If your child is having tantrums that you can’t explain, that are getting worse, the tantrum is the frustration they feel being unable to express themselves and what they need.

Ordinary kids experience everyday life without too much tumult. They don’t know what’s going to happen tomorrow, or the next day and they’re just fine with that. Things are vague and abstract? Not a worry.

Create a sense of certainty

But anxious kids are not fine with that. We need things to be concrete; we need to know what’s going to happen. This is what anxiety is—the dread of uncertainty. The dread of discomfort. The fear of feeling fear. Of course, no one knows what’s going to happen tomorrow or the tomorrow after that, but teaching your child how to break down abstract concepts like time is a good place to start.

My sister, Kara, did something with one of her daughters that was eye-opening for me. Every night at bedtime, she walked her through the day she’d just had. Then, she walked her through what would happen tomorrow. She told her what to expect so that she knew what was coming.

She created a SENSE of certainty. Watching this blew my mind. It was the simplest thing in the world, but it was life-changing for me. Now, before I go to bed, I run through the next day so I don’t feel paralyzed when I wake up.

Don’t lie

When your anxious kids have questions, answer them. When they ask hard questions like, “What do I do if you don’t show up?” Don’t say, “I’ll show up”; or “That’s not going to happen.” The question isn’t whether or not it will happen; the question is What should they do?

This is the heart of anxiety.

We don’t know what to do in the face of uncertainty, and being able to have a plan, or talk things through, both soothes and alleviates anxiety.

When their questions are brushed aside with insincere answers, kids will never learn how to self-soothe, manage difficult situations, or make life-saving decisions in crisis.

So answer them. What should they do if you don’t show up? Who will they live with if you die? Tell them. Knowing what will happen creates a sense of certainty, and they not only need this from you, they need you to teach them how to do it for themselves. Answering their actual questions does both.

Many people worry that acknowledging these types of questions will trigger anxiety in their children, but they have it backwards. Withholding answers to their questions is what will trigger anxiety in them.

Anxious people are constantly pushing back against reality. The true cause of suffering is our inability to accept things as they are; we get caught on “if only” and “what ifs.” When a child is told not to worry when they are already worried, when a child is told that their parent won’t die when they ask what will happen to them when they do die, they feel gaslit. These denials and dismissals teach children that their questions aren’t important or worthy of being answered. If this continues, these kids will grow up learning to deny and dismiss their needs.

Answering their questions will free them from feeling trapped and will allow them to grow and move forward. To deprive them of answers is to keep them trapped in their extreme anxiety.

So, parents of anxious children, try to remember that your child knows things you don’t, like how it feels to be chronically worried. You have a lot to learn from them, and you have a lot to teach them, but you can’t teach them what you don’t know.

Don’t remove the obstacles!

When we remove obstacles from our child’s path, we are choosing something easy in the moment, which will make your child’s life harder in the long run. Instead, what if you could do the harder thing in the moment—which is bolstering their strength and reserves and ultimately, their confidence, by sending them off to face their fears, knowing they’re capable. In the long run, you’re making life easier for your kid. (To do this, see: research, below.)

We tend, as a people and a society, to be short-sighted. We don’t project far into the future, anticipating outcomes of current events (I’m looking at you, climate change!) and preparing to either thwart or face them head on.

What if, instead of waiting until issues are already set in place, we work to do the harder thing first, so that we can set our child up for success as an adult.

Research!

There are plenty of incredible books out there for parents of children. Here are two of my favorites to get you started: Freeing Your Child From Anxiety by Tamar Chansky, and The Worry Cure by Robert Leahy.

Finally, instead of beating yourself up for not knowing what to do, learn what to do, and then tell your child that you’re sorry.

You’re sorry that you haven’t known how to handle their particular worries, but now you’re learning. Admit when you make mistakes, tell your child that you didn’t know what to do in this or that instance, but now you’re learning. But most importantly, apologize for your mistakes.

Then, ask your kid if they’d like to go on a worry adventure with you, and learn all about this extraordinary depth of feeling your child possesses, together.

But here’s where real change comes. Parents of anxious kids are so bent on helping their children, they look for solutions instead of trying to understand anxiety, where it comes from, what it feels like, how it manifests differently in everyone, and where it might live inside you.

When we learn about our own anxieties, we can learn the tools we need to manage our anxiety. And it’s only when we understand how to help ourselves that we can truly understand how to help another person. At the very least, it will help us empathize, and that’s a hell of a running start.

TO RECAP:

Children never “act out” for “no reason.” There is always a reason, but their vocabulary to articulate the reason is limited. 

Walk them through transitions. Help them by being a bridge for transitions. Be the bridge between day and night, now and then, today and tomorrow. Walk them through what is going to happen.

Don’t lie! Be honest with your kids. They know when you're lying, even if they don't have the words for it. If you lie, they may have trouble trusting you.

Research! The way to understanding your child’s anxiety is to begin to understand what anxiety is, how it manifests, and where it lives and how it manifests inside you.

And just remember, everyone’s got something, and this is your kid’s something. Maybe it’s one of many somethings, but no matter how many somethings your child has, learning about each one separately and together, in order to live with more ease, is the absolute best gift a parent of an anxious child can give.

Amanda Stern