Answer
My daughter, who is seven, can easily get anxious and overwhelmed, particularly around unexpected changes or transitions in daily routines. Sometimes, things escalate quickly into angry outbursts and sometimes violence. She became hysterical getting out the door for school after the Easter holidays and took ages to calm down. In the heat of an outburst she can follow me around shouting at me and sometimes hitting out. No matter what I say it seems to make her more aggressive.
When the meltdown is over, she is devastated by her actions and hates herself and doesn’t understand why she was so angry. I worry more about the self-hate after the meltdown.
She experiences significant separation anxiety and will barely leave my side, which means she refuses to participate in activities and has difficulties making and maintaining friendships with peers. She is on the waiting list for an assessment and we suspect she might have ADHD/autism.
What can I do to help her?
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Answer
Many young children experience anxiety at the prospect of being apart from their parent, especially when they are not in control of the separation or if it feels “forced” upon them. For these children, the presence of the parent is associated with feeling safe and secure and they can experience agitation and panic if the parent leaves. Your daughter also finds unexpected changes and transitions challenging.
In a similar way, predictable routines help her feel secure and in control as she knows what is coming next. Changes to routine, especially unexpected ones, can invoke a strong stress reaction. Both separation anxiety and difficulty with transitions are common for autistic children and they can amplify each other. It is not surprising that your daughter’s anxiety might peak at the prospect of returning to school as it means she is both separating from you and transitioning to a new school routine. In addition, there could be other stresses in school that add to her anxiety such as social challenges or coping with the school environment
Understanding your daughter’s outbursts
Intense emotional outbursts and meltdowns are often perplexing to both parents and children. Your daughter’s outbursts are not necessarily a rational response to circumstances but a sign of her stressed nervous system “freaking out” to the perceived threat of being separate from you (her main comfort) while also jolted out of the security of her routine. Such overwhelming stress invokes either “fight, flight or fright” reactions, which can show as shouting and aggression. This of course can be distressing to witness as a parent. Your situation is complicated by your daughter’s separation anxiety. Understandably you might want to criticise or pull back when she is angry or aggressive, but this can inflame her panic and cause her to react by pursuing you physically. Though she is venting her frustration at you, she is also looking for your support and reassurance.
Responding to the outbursts
When responding to your daughter’s outbursts, the goal is to try to de-escalate the situation and help her regulate and return to a more balanced state. This might mean pausing the demand that is triggering her such as taking a break from the school journey/preparations to give you more time: “It’s okay, we can go in a bit later, when you are feeling better.” Then it is about discovering what helps her relax and regulate – different things work for different children. Given her separation anxiety, it is likely she needs you close by and present to help her.
This might mean sitting quietly with her using comforting relaxing words such as “shh, its okay ... it is all fine”. Depending on her sensory needs, she might need a hug or her hand held or just your presence beside her. The key is to manage your own reaction so you keep your own angry or negative emotions in check. Make sure your tone of voice and body language are soothing – a good rule is that if she shouts, you calm your voice more. Or if she stands up, you keep sitting down in relaxed way. Co-regulating with young children during the heat of a meltdown requires a lot of patience and is one of the hardest things you have to do as a parent.
Talking afterwards
It is a good sign that she is “devastated” by her actions after the outburst – this means she has some awareness about her behaviour and that she wants to manage better next time. In discussing what happened it is important not to judge or criticise but to instead help her compassionately understand herself. If she says she “hates herself”, be very reassuring: “It’s okay, everyone can get upset when they are in a panic”; “you are a really good girl and I love you very much.” You can help her understand her reactions by asking questions such as: “What is the first thing you notice in your body when you are getting panicky?”
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What can she do relax her body? I often invite young children to draw what they feel on a pictorial body map so they can begin to understand where they experience their feelings in their bodies – this can also give clues as to what sensory experiences help them regulate and relax.
Preventing problems
Take time also to think through how you can prevent stress accumulating for your daughter. How can you prepare her for transitions and changes – would early warnings of an upcoming change or a pictorial chart of next steps help? It is also worth checking in with the school as to what stresses she might be experiencing there and to see what additional supports might help her.
- John Sharry is clinical director of the Parents Plus Charity and an adjunct professor at the UCD School of Psychology. See solutiontalk.ie
