IT’S COMPLETELY NORMAL for children to have intermittent fears. These could be fears of being away from you, having monsters in their room at night, getting a shot or loud thunder. Typically fears come and go, and while your child may feel afraid, they’re still able to get on with their life – they go to school, play with friends, fall asleep at night and so on.
Phobias are remarkably common in children. Upwards of around 9% of children (or about 1 in every 11 kids) will have a phobia at some point – girls more frequently than boys. A phobia is an irrational, intense fear of an object, animal, person, situation or place that poses very little or no real harm.
Typical phobias in children involve animals, insects, blood or needles, thunderstorms, heights, flying, the dark, getting sick or having a loved one get sick. A phobia can start for a variety of reasons. A child may have or witness a traumatic experience with the object of their fear or even just hear about such an incident, like a dog biting someone.
A child can see a parent who reacts with phobic fear, like a mother who is intensely afraid of spiders, and essentially learn the phobia. But phobias can also run in families, as can all anxiety disorders, such that there are some children who will genetically inherit the predisposition to a phobia. Amazingly enough, it is often a phobia of the exact same thing that scares other family members.
A phobia may also be what’s called a displaced fear. For example, a child who is in a car accident, and in their mind connects that it was raining at the time to the accident, could develop a phobia of thunderstorms.
Unlike a temporary fear, a phobia causes more extreme symptoms when the child is confronted with the feared object or even when they think about coming into contact with what they fear. Typical symptoms include:
Feeling shaky or trembling.Nausea.Sweating.Feeling short of breath.Chest pains.Rapid heartbeat.Feeling like they’re going to die or go crazy.Feeling numb or having chills.
They could experience one or two or many of these symptoms. As a result, children with phobias will start to go to great lengths to avoid the feared object or situation or even anywhere they think they might encounter it. Additionally, a phobia will start taking up extra room in their mind as they worry about encountering what they fear, such that they seem preoccupied or have trouble concentrating.
In nearly all cases, phobias should be treated. They can interfere with your child's ability to participate meaningfully in social relationships and school and get in the way of reaching development milestones. What’s more, phobias are very treatable, treatment time is limited, and the earlier a phobia is treated, the faster it tends to respond to treatment.
If your child is phobic of something he or she will rarely or never encounter – like snakes and you live in an urban environment – you might choose to ignore it; and it’s possible over time it will go away without having any impact on the child's life. But if the phobia is of something that will impact your child’s life, such as thunderstorms, heights, flying on an airplane or dogs, then it’s important to get treatment.
Most children can be and should be treated with cognitive behavioral therapy. This consists of helping the child examine the fear and see the ways in which they have overestimated the danger. Then the therapist will begin exposure. Sometimes exposure begins with simply talking about the object or looking at pictures of the object and practicing relaxation techniques to calm the body at the same time, then building up to more exposure over time until the child is able to be with the object and stay calm.
If a child's phobia is so severe that it makes exposure impossible, medication may also be prescribed to treat the child's anxiety. This will help diminish the child’s fear to allow the child to learn how to cope with being exposed to whatever they fear and continue on with the therapy. The medication can be stopped over time after the phobia has been treated successfully with therapy. by Dr. Gail Saltz
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