Dr. Bonnie Zucker, Psy.D., speaks at TNCS about the importance of teaching our kids how to manage stress and anxiety.

Parents came out in droves on Wednesday to attend the inaugural presentation of The New Century School‘s new lecture series. Dr. Bonnie Zucker, Psy.D, a psychotherapist at The National Center for the Treatment of Phobias, Anxiety, and Depression (Washington, D.C.) and at Alvord, Baker, & Associates (Rockville, MD) spoke to the audience about using cognitive behavioral therapy (CBT) to reduce or completely abolish anxiety disorders in children. You might think that handling kids’ anxiety and related emotions tends to be the provenance of mothers, but the number of dads present disproves that assumption. Anxiety disorders, evidently, do not discriminate along gender lines. Nor do they prefer adults so much any longer. Pyschopathology rates have been skyrocketing in children and adolescents for several decades, according to the American Pyschological Association; some even call this The Age of Anxiety. Kids can begin to manifest anxiety disorders as early as age 4 or 5 years.

Anxiety is a normal response to stressful situations, but chronic anxiety can cause a cascade of health problems, from depression and substance abuse to serious digestive disorders (e.g., inflammatory bowel disease, irritable bowel syndrome, ulcers) and heart disease. Learning to manage our response to stressors can significantly reduce the health risks associated with anxiety as well as make daily living altogether more enjoyable. And that’s exactly what Dr. Zucker helps parents to do: “I speak about five times a year at schools,” she says, “targeting parents to be more aware of their kids’ anxiety and giving them strategies to help them manage it whether it’s a disorder or not.”

In her presentation, we learned first and foremost that the tools she would be demonstrating are useful for everybody—“there’s nobody who doesn’t get stressed,” she made clear. Several parents attended for just that reason: Sundai Valcich, mother of three kids ranging from age 1 year to age 6 years, said, “My children do not have severe anxiety at this point in their lives, but I thought it would be useful to learn some techniques for how to address anxiety should it occur. Dr. Zucker presented some great techniques for helping our children—and ourselves—deal with anxiety. I hope to introduce ‘calm breathing’ to my family to help all of us do better in stressful situations.” More on calm breathing in a bit.

A full house in Building North came out for the Anxiety-Free Kids presentation. And they kept coming!

Other parents wanted to know how to distinguish between natural anxiety responses and potentially problematic ones. Dr. Zucker emphasized that anxiety only becomes a true problem—a disorder—when it interferes with daily living. When a child cannot attend a birthday party because social situations stress her out, that’s an interference. When a child can’t go play baseball at the park because he might encounter a dog there, that’s an interference. The fact is, anxiety disorders are the most common form of psychopathology in children, adolescents, and adults. Moreover, a strong correlation exists between childhood and adult disorders; if you were an anxious child, you may well be an anxious adult. Nipping excess anxiety in the bud, even learning to recognize it, will set our kids on a healthier mental path. Another TNCS mom of three, Meredith McCormack, says she came because, “I was interested in learning about what type of behaviors might signal an underlying problem with stress and anxiety and I thought that practical tools for addressing anxious behaviors would be helpful. I thought that the talk was great and very interactive. The fact that Dr. Zucker got on the floor to demonstrate deep breathing techniques was a good example of the types of very practical examples that she used throughout the talk. I was very glad that I attended!”

Dr. Zucker demonstrates the calm breathing technique in her interactive, informative, and very entertaining presentation.

So what did Dr. Zucker show us? As mentioned, her approach is CBT. Anxiety, she says, affects our bodies, our behaviors, and our thoughts. By repeatedly exposing a child to his or her anxiety trigger, in a safe, controlled environment, Dr. Zucker can teach heuristics to deal with these effects. So, when the little boy who can’t play in the park sees a dog, his muscles probably tense up, his heart rate accelerates, and his stomach might even hurt (indeed, Dr. Zucker explained that our digestive tracts are home to greater quantities of neurotransmitters than even our brains, giving credence to that old claim of a “nervous stomach”). These bodily effects can be lessened with calm breathing, yoga, meditation, and guided imagery, for example. (A huge advocate of yoga and meditation, Dr. Zucker, exhorted everyone present to take up these activities if they have not already done so and “call [her] in a year” to thank her for the resulting life improvements :)!) We can employ calm breathing in any situation but, first, refining this technique is necessary–it’s not a simple matter of taking deep, slow breaths. To practice calm breathing, lie down (Dr. Zucker recommends donning a yoga mat) and place an object on your chest. When you inhale, if the object moves, you are not breathing calmly! The breath should originate from the deep, low abdominal muscles; the chest remains static. It’s harder—and therefore far more rewarding—than it sounds!

Next, our little boy needs to address the avoidance behavior he resorts to out of fear. “Behavior change happens first;” says Dr. Zucker, “thought change comes second.” At the child’s pace, expose him step by step to dogs or to dog-related situations. “Face your fear!” she says. She makes “ladders” to help the child both chart and see his progress and to convey a sense of climbing/achieving. One rung at a time, the child conquers his fear. (Works for adults, too!) As for thoughts, the little boy is probably experiencing a lot of worry as well as “negative self-talk” (e.g., “I can’t”) and thinking “errors” (e.g., magnifying/distorting the intensity of the problem). To address the thought component, Dr. Zucker suggests replacing the errors and negativity with positive thinking, and, here, practice makes perfect. “Anxiety breeds self-doubt,” she says. “Fostering resilience can prevent self-esteem issues.” Thus, our body, behaviors, and our thoughts intersect and influence each other continuously. Harnessing this interaction is the key to CBT and using it to overcome anxiety.

Sample ladders that Dr. Zucker has used to combat a variety of anxiety manifestations.

This sample ladder shows the steps to overcoming social anxiety. Smiley stickers are awarded for progress :).

We can thank Head of School Alicia Danyali for introducing us to Dr. Zucker. “I thought bringing someone into the school with expertise in the area of anxiety would speak to many families that have their own questions about their child’s behaviors, and to confirm or cancel out any ‘anxiety’ they may have regarding their observations. Also, in this overstimulating world, how does overstimulation affect those predisposed to anxiety or any signs of these behaviors mentioned in the talk?”

Dr. Zucker’s take-away message is clear—teaching our kids how to manage anxiety and anxiety-inducing situations is on us parents. We need to both educate ourselves in CBT techniques, and we also need to model our own correct responses to stress. “I look at managing anxiety as a life skill,” she says. She’s right on target. We cannot delude ourselves that our kids are never going to experience these unpleasant emotions or that we can always shield them from situations that might induce such feelings. What we can do is teach them how to rally and move on. Yes, you have to get a flu shot, and, yes, the needle is going to hurt. It’s okay to cry, but know that it will be over quickly, and you’ll be just fine. There’s that buzzword resilience again!

Want to learn more? Check out Dr. Zucker’s book, Anxiety-Free Kids: An Interactive Guide for Parents and Children!