behaviorally inhibited temperament

Seven strategies to use with young fearful children

As I witnessed the various atypical behaviours from my daughter (a selection of which are listed in the previous post), my partner and I started developing solutions. We fine-tuned our strategies as we read more articles and books. Here are some of the most successful solutions that we used from when our daughter was 7 months to the present time. 

  1. Our basic “discipline” guidelines and strategies came from reading Peaceful Parent, Happy Kids by Dr. Laura Markham. This positive parenting method has nothing to do with anxiety, but we found it a useful approach for coping with the regular trials of parenting (conflicts!). Markham describes an approach to discipline called “Empathic Limits”. In brief, discipline starts from a place of connection or attachment between parent and child [more info]. Then, the parent sets and enforces empathic limits using these steps:
    • Get down to the child’s level (with eye contact or physical touch)
    • Join with the child, “It looks like you’re having fun throwing sand”
    • State your concern, “I’m concerned someone is going to get hurt”
    • Use calm, kind, empathetic words as you set the limit, “I do not want other people getting hurt with sand, so let’s find a different way for you to use the sand now.”
    • Acknowledge her point of view as you set the limit, “It’s hard to stop what you are doing. But it’s time to find something else to do.”
    • Whenever possible, offer a choice, “Do you want to drive the truck through the sand or play on the slide now?”
    • If needed, calmly enforce an action, “I see you’re having difficulty safely playing in the sand where our friends are playing too. We are leaving the park now. We can try again tomorrow.” (aka “bring on the crying!”)
  2. For the long period of time when my daughter would “freeze” on the sidewalk and stare at another person until she burst out crying, I tried to “catch” her before the freeze by touching, talking and picking her up to comfort. Some people might think that this is rescuing behaviour which can actually make anxiety worse in the long run, but I thought it was more important to prevent the “freeze” response. My goal was to stop her brain from entering the freeze/fight/flight state, in which her brain and body would be overwhelmed by stress. I wanted my touch, words and voice to still have some influence before her automatic primitive brain took control. In hindsight, this “catching before the freeze” could be an early rung of an exposure ladder for an eventual goal of greeting our neighbours. Each step of an exposure ladder requires the anxious person to control their behaviour and commit to the step. If their brain is overwhelmed by stress and in a fight/flight/freeze, they are not in control. At 3 years old (and under pandemic conditions), my daughter rarely enters the freeze/fight/flight response. She will say, “no” and be resistant to novelty but she typically will not become paralyzed with fear anymore.
  3. A second strategy we employed for passing people on the sidewalk was to hold my daughter’s hand while we passed someone and label the person as a “kind neighbour out for a walk like us”. Usually, she did not like holding hands but when passing another person, holding my hand gave her the safety and comfort she needed to keep moving forward. The more times she walked by people without stopping (and freezing), the more times she experienced nothing bad happening! Although holding her hand does not directly address her fear of other people, the act of walking past people reinforces the tangential idea that there is no threat on the sidewalk. In addition, by labeling the person as a kind neighbour out for a walk, I created a familiar connection of someone being kind. This was a concept we had already celebrated when we first met a “kind doctor” when my daughter had a potential UTI. As well, it was a commonality between my daughter and the neighbour: they both like walking! At 3 years old, we still talk about neighbours walking in the neighbourhood and we practice brave talking.
  4. Bring a comfort toy (lovey) to all outings. I used this strategy based on our sleep consultant’s suggestion to provide an object that can be used to self-sooth for independent sleep and I was trying to create an attachment between my daughter and the object. It was so successful for sleep, comfort and soothing that I kept using it for general comfort for anxiety behaviours that typically occurred in social settings. Many people envision Charlie Brown’s Linus and his seemingly disgusting blanket being dragged around in perpetuity when they think of a child and her “lovey”. And in some respect, that’s true! (It’s good to have multiple loveys so they can be washed!) The lovey was one of the only things that allowed my daughter to calm when she escalated to fearful crying after freezing. Due to her sensory processing differences, my daughter dislikes being held, touched, hugged, etc., except on her terms, so having a lovey gave her comfort when hugging an adult was not helpful. At 3 years old, she brings a favourite toy outside and rarely uses it for comfort, but it is there if she wants it. She has loveys inside that still provide lots of comfort and joy. Maybe she will always have something soft to snuggle as she gets older. She may always need a lucky “rabbit’s foot” for comfort and I would rather she have a comfort object than to seek out food, cigarettes, drugs and alcohol to fill that need. Is Linus really so bad?
  5. Use a “brave” phrase to encourage my daughter to physically move forward: “1, 2, 3, go”. She would say this phrase at the top of a slide and then push herself forward, at the edge of a field to start running, and to continuing walking on the sidewalk before entering a “freeze” state. This was surprisingly successful. My partner and I would say the phrase and smile and encourage her to come forward and eventually she started saying it. I would even hear her whisper it and I could see her using it as a self-motivation tool. We have just recently returned to using mostly empty playgrounds since the pandemic and for the first few slides, I heard her counting to herself before pushing off! She no longer uses it for walking or running – she just walks and runs!
    • Note: Many inhibited children are also physically timid. When I described my daughter at almost 3 years old to the public health nurse, the nurse was shocked that she jumps, climbs, runs, rides a scooter, and rides a push bike. She was surprised my daughter was so physical. Since she was 7 months old, I have spent a lot of time at local parks and playgrounds every day. We were often the only ones there in the morning rain or shine. This allowed me to encourage physical bravery and physical movement without the inhibiting social factors of other children in busy playgrounds. She built confidence and had a natural interest in going fast, moving her body, and getting from one place to another. When we would go to busy playgrounds, she moved less, observed more and I had to “hover” much more because if she froze, she might suddenly let go of a ladder or swing or walk off a platform. But, as time went on and her confidence built, she was able to physically move past other people because she had enough muscle memory and confidence to keep her body moving even when her mind was in a state of stress.
  6. Lisa went through a few phases of being afraid of various slides and of sliding too fast. We showed her strategies of slowing herself down by using her hands and feet or by sliding on her tummy. As she went down the slide with a strategy, we would describe what she was doing and how she was controlling her speed. This gave her confidence that she was in control and she was safe. Eventually, she started sailing down the slides at full speed again!
  7. Modelling expected behaviour for child-to-child interactions. At busy play gyms or play spaces, I try to intervene with other children just prior to a physical altercation (which would then put my daughter in freeze mode). I spoke the words for my daughter saying things like, “No, my turn” or “I want to get out”, and I would describe to the other child what was happening, “She is using this toy. She is having a turn. You can have a turn when she is finished” or, “She is trying to get out of the house”. My daughter still has trouble speaking to others, but she is able to say these types of phrases to her cousin and she started turning her back to show kids at play gym that she was still using a toy. It’s not the ultimate behaviour I want, but they are steps in the right direction: remaining in control of her brain (staying out of the freeze state), using her body in a coordinated manner to express possession/turn-taking through body language, and starting to use appropriate phrases with another child in a low-anxiety setting.

You might notice that the outcome from some of these strategies does not meet your expectations for your child. You may feel strongly that they should not carry a stuffed animal when they are school-aged. And I completely understand why! Kids who are different are more likely to be teased and bullied at school. Unfortunately, your kid is who they are. You can try to change them into something else, but somewhere along the line that will probably backfire through rebellion or a poor parent-child relationship. However, you could prioritize weaning from a lovey at social settings like school and develop a story to help your child willingly leave the lovey at home. There are a few ideas to keep in mind when you think about your child’s behaviour and your expectations: are your expectations reasonable for your child’s age and developmental stage (i.e. make sure you are expecting typical or normal behaviour at the most, not advanced behaviour)? Are your expectations reasonable for your child’s inherent personality (given you may have an inhibited child, should you adjust your expectations)? If your child is not meeting many expectations, what are the priorities? Answering these questions may help you decide which goals are important and which ones you will let go of, for now.

In my next post, I will describe our play-it-out strategy that has evolved into a useful multi-purpose tool to help us process past events and prepare for the future.

Secure attachment and attachment parenting

Secure attachment between child and parent is now recognized as one of the most (if not the most) powerful and important influencing factor on a child’s wellbeing. Attachment has been tested by researchers using the “Strange Situation” experiment. The results of the experiment indicate whether the child is attached and how they are attached to the parent. In fact, the first thing our child psychologist did when she met my daughter and me was to conduct a version of the “Strange Situation” to confirm that we were attached. The psychologist said that there was no intervention for anxiety or any other problems that could be administered without attachment. Attachment appears to be generated through responsive parenting during infancy and babyhood. It is not simple to define exactly what behaviours the parent needs to exhibit to create attachment. There are many roads to having an attached child.

Attachment parenting is a parenting philosophy first proposed by Dr. William Sears with basic advice about how to parent with the goal of creating a secure attachment between parent and child. The problem is that the specific strategies are not all supported by research as necessarily creating secure attachment. Unfortunately, much of the advice can end up creating unnecessary stress on the parent-child relationship when the parent, for any reason, doesn’t follow the advice (i.e. vaginal delivery, breastfeeding, baby-wearing) and instead feels guilt, shame, and anxiety about not doing what Dr. Sears recommends. For some reason, this parenting philosophy seems to have created a militant following, such that there can be associated parent- (usually mother-) shaming if you don’t do attachment parenting. If you strongly support Dr. Sears’ attachment parenting philosophy and it has worked for you, that’s wonderful, but it is not the only way of creating a secure attachment with a child and for many parents and children, other strategies are more successful at creating a secure attachment and maintaining the parent’s mental health.

This article is a great summary of the differences between secure attachment and Attachment Parenting by developmental psychologist Dr. Divecha. This article is a summary of how a parent can create a secure attachment with their child and provides an interesting comparison between “secure attachment” and “bonding” (terms that are often incorrectly used interchangeably).