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How to help a child with a phobia

Phobias can disrupt a child's usual daily activities. They're different from run-of-the-mill fears in their severity.

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UNC Health Talk
Editor's note: This article originally appeared on UNC Health Talk.
Nearly all children experience fear and anxiety sometimes. Toddlers may fear the dark or monsters, while school-age children might worry about physical injuries and teens often experience social anxiety. But some children experience severe, debilitating fear around a specific situation or activity. These fears are known as phobias.

Phobias can disrupt a child’s usual daily activities. They’re different from run-of-the-mill fears in their severity. For example, it’s normal for a child to be a little afraid of getting a shot, but a child with a needle phobia will be in great distress when it’s time for an injection.

“A phobia is when someone has an extreme panic reaction to something,” says Dr. Rebecca Taylor, a UNC Health child and adolescent psychiatrist. “Every time you encounter a feared stimulus, you have paralyzing fear, panic symptoms, and you really can’t get through it.”

Another example: Any child might be nervous around a large dog, clinging to mom or dad and not going near it. But a child with a dog phobia will be clearly terrified, “melting down, screaming and having this ginormous reaction that seems out of proportion,” Dr. Taylor says. Phobias tend to last six months or longer, unlike more temporary and less severe fears.

Some Children Are More Prone to Phobias

While everyone is primed to be fearful of some things, such as being in a car that’s careening out of control or encountering a bear, some people develop phobias because they are more prone to anxiety. “There’s a lot of overlap with generalized anxiety and a specific phobia,” Dr. Taylor says. Researchers think people may be more prone to anxiety, including phobias, for both biological and environmental reasons.

Like adults, children can have phobias that center on almost anything, from certain animals or spiders to heights or the dark.

In addition, if a child has been through a trauma, such as being attacked by a dog, it is normal to have a “phobic reaction” to things that might remind them of that trauma, Dr. Taylor says.

“If you experience an attack by a dog at a young age (trauma), it often then generalizes to all dogs, and being around dogs will create panic symptoms, and the dog becomes a feared stimulus,” Dr. Taylor says. “Even seeing a dog nearby can lead to panic/phobic symptoms.”

Be Mindful of How You React to Your Child’s Phobia

As we know, children take their cues from the adults around them.

“If caregivers or parents can maintain calmness and reassurance, it goes a long way,” Dr. Taylor says. “Kids are always paying attention, and they look to the people in their lives. If you’re anxious as an adult, make sure you are handling anxiety in a way that is going to be what we would want to see them do.”

If you are struggling to control your own anxiety in a healthy way, it’s good to seek therapy. There, you can learn coping skills that can help you and your child.

Talk to your child about the phobia when you’re not in the midst of the triggering situation. Acknowledge your child’s concerns with compassion, but do not increase or reinforce them. It’s also important not to minimize your child’s fears or belittle your child for having them. Even irrational fears should be treated with respect; being shamed can amplify your child’s anxiety and is likely to make the problem worse.

“You could say, ‘It’s normal. We all get nervous. We all get scared, and that’s OK,’” Dr. Taylor says. “We want to make sure they feel safe first, and then can talk to somebody, learn how to address the fear themselves and how to get over it.”

Get Help if Needed

Children with phobias do not always grow up to be adults with mental health problems, but children with phobias are more likely to deal with chronic anxiety, which can lead to difficulties later in life—and needless suffering. That’s why it’s important to get help.

If you think your child may need help but you’re not sure, talk to your child’s pediatrician. Psychotherapy (talk therapy) may help. A therapist can help your child talk through and develop coping skills to control anxiety and panic attacks if they happen.

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