Helping 8 year old with generalized anxiety and scary thoughts

While I am not autistic, I had a very similar experience with anxiety as a child at the same age as your son - a lot of existential anxiety/dread that wasn't tied to any particular scenario and became especially problematic around bedtime. It caused a lot of emotional turmoil at the time. My parents took me to a psychoanalytic child psychologist who was unhelpful (and may have caused more harm than good). As someone with expertise in clinical psychology now, I wish my parents had found a good child psychologist who was an expert in CBT. At the very least, this sort of therapy could be helpful in assessing what's going on, gaining clarity on the fear (which in itself might make it less scary for your son), and testing out some ways to address it, potentially giving you & your child some skills to test out. One great thing about CBT is that it is goal-based and the therapist should be clear in their communication about what they are doing and why, so you can more easily assess whether it's working for you. You should be able to expect that a psychologist would start with an assessment (a semi-structured conversation, probably 60-90 mins) with you and your son and let you know whether THEY think CBT would be a good fit and why/why not before you jump into therapy. If you have the time and $$ to take this approach, I'd recommend it!

Hi pre48,

I am a psychologist at Stanford on the adult side, but our pediatric psych department has lots of great resources! I'm sure they could identify a provider that would work with your son. You can call the Dept. of Psychiatry at 650-498-9111. If the waitlists are long, they should have a list of community providers that they recommend.

If the sleep anxiety is it's own phenomenon, Rachel Manber, PhD, is a world-renowned sleep psychologist who sees children through Lucile Packard. She is spectacular and offers treatment through telemedicine so she can help you anywhere in California. I think you just call the same number listed above and ask to be referred to her pediatric practice. 

Hope that helps!

My daughter has really liked CBT workbooks for kids. Her favorite is When Harley has Anxiety. Feel free to send me a message if you have questions!

I'm sorry your son is experiencing this. How scary and uncomfortable it must be for him. I can't speak to the autistic part, but I can share my experience with my child's general and specific anxiety challenges. 

During 3rd grade, my child's anxiety became life limiting, and they began to develop very frightening anxiety attacks. My child engaged willingly in CBT therapy with a very skilled practitioner (no longer in the area). The therapy was focused, effective, and of limited duration. They had/has both generalized anxiety and separation anxiety that presented very young (toddler). Over the years they have dipped in/out of CBT and DBT (very structured, kind of like CBT+). They have never been on medication (although we've tried to get prescription a couple of times). I suspect they will always experience anxiety to a degree. They have learned to manage it. They are a high performer, meeting all developmental milestones as a young adult, and even went across the country for college and have traveled and lived internationally for summer internships. In their early 20s, they are now very self-aware and articulate about their anxiety and pay careful attention to self-care.

In my experience, the two best things I did for my child were (1) finding a skilled therapist trained in CBT (proven to be very effective for treating anxiety) they connected with and (2) educating myself about anxiety and learning skills and tools to support my child through their stages of development. I did this through classes and reading. This list may help you find a book that resonates with you. I've read many on the list at various times and found them to be helpful.

I applaud you for the calm tone of your email and for taking the anxiety seriously. The earlier children can begin to manage their anxiety, the better they will be able to manage it through their various stages of development.

CBT isn’t recommended for young kids, under 8 for sure, and often under 10-12, their brain development just isn’t there yet for it to work well. My daughter has anxiety (eventually diagnosed with OCD, which is on the extreme end of the anxiety spectrum). What worked extremely well for her beginning at age 7 was a therapist well versed in Exposure Response Prevention Therapy. It’s all about learning to recognize the physical manifestations of anxiety in your body, and learning how to sit with that discomfort and then push through it, not avoid it. “You can’t deep breathe your way out of anxiety” was something the therapist told us early on that clicked for me. My daughter is doing amazingly well now, I wish we hadn’t wasted our time and money on all the other therapists and doctors we tried first. Good luck!

Similarly to the previous reply, my parents also took me to therapy for the first time around the same age due to anxiety that worsened at night, causing difficulty sleeping. I don’t have autism, and I did have specific fears, but what helped a lot in addition to CBT was mindfulness practices such as doing a body scan while I was lying in bed trying to sleep. Today, there are a ton of mindfulness resources actually designed for kids. Good luck and all the best to your family. 

Hi there — this sounds so hard! I have 2 things to offer —

1. our almost 8 year old has had lots of fears at nighttime — there’s been a noticeable increase in the past 6 months — our family therapist says that this is age appropriate and it will pass, and we should offer more supports at night as needed (nightlight, staying in room longer) even though it might seem regressive.

2. I would suggest finding out more about what the sensation is that your child identifies as ‘anxiety’ — is it felt in a part of their body? Are there particular times of day when it occurs (eg, transition times, down time when your child might be at loose ends, etc) — our child w ASD felt deeply uncomfortable with how unpredictable he found other people to be, I wonder if your child is experiencing a similar response to the “neurotypical” world around them?

   best of luck to you

I'd recommend checking out Bay Area SPACE Treatment (Supportive Parenting for Anxious Childhood Emotions). We did the parent group workshop series and have found it very helpful for how to respond to our 6 year olds anxiety.

https://www.bayareaspacetreatment.com/

Also, check out the Flusterclux podcast with Lynn Lyons (https://www.flusterclux.com/). Lots of great info for how to handle anxiety in kids & families.