PARENTING BOOK REVIEWS: My Not-So Little Library (Part 2)

So, as promised in this post, I am taking a moment to acknowledge and recommend the top parenting books lining my shelves (or downloaded, as the case may be).  I admit, this was hard. I am not saying that I’m picking winners all the time, but it was really difficult to narrow down the “best” ones, probably because each was well-written on a very discrete issue. But, I think I can narrow it down to the top 8 parenting books I’ve read since M was born. I  have a lot to say about some of them, so I think a post about a particular book will be best, so stay with me over the coming days. Ready? Here we go . . . book 1:

Growing Up Brave: Expert Strategies for Helping Your Child Overcome Fear, Stress and Anxiety, by Donna B. Pincus, PhD.

OK, even though these books are not listed in any particular order, I must say that this book, hands down, was the single most influential book for me. I just finished it about two weeks ago. It completely changed the way we were handling some situations with M, who happens to have a very anxious temperment about certain situations. So much so that we actually sought and engaged with some professional help as well over these past few months (which has worked in its own right).

The premise of this book is cognitive behavioral therapy, or CBT, and it has worked true wonders for M and our family over these past several months. I’m torn about whether to fully explain the situations we endured, because to do so will undermine some semblance of privacy that M has. I need to sit on that for a while. But suffice it to say, when you have an anxious child, you just know. In our case, there were actual physical manifestations as well. It’s not always apparent when they are really little because there are so many phases or things that come up that cause “blips”, but after several years of seeing your child struggle with the same issues over and over, you begin to realize that it’s more innately part of her nature or personality. They don’t “grow out of it” as so many well-meaning people will try to encourage you.

And so you want so desperately to help your child function (as best she can given her own leanings and the demands of the world around her) and be a “normal” kid who can do “normal” things. Like get in the car and go more than 5 miles without having to stop for a pee break—I am not exaggerating; this was our situation for almost a full year before we realized there were some things going on that were causing her to pee so frequently, and after too many specialists and tests, we now know those things were (1) constipation (stay tuned for a future book review related to this issue) and (2) underlying anxiety (also somewhat of a chicken/egg thing going on there between the two issues, but that’s for another day). Of course this means you really cannot travel far (we even have a potty in our car) and it becomes hard for others to understand why you are not participating in outings and such. When your otherwise even-keeled daughter has a meltdown just to get out the door because she is already anxious about when she will next have access to a restroom (not to mention it couldn’t be a restroom that was too public/noisy/etc.) It didn’t matter if the trip was to the hardware store down the street or to her grandparents’ house an hour away. All travel required having immediate access to a bathroom.

And then this past October she quit her second year of ballet after just a few weeks because she was taking more than 7 bathroom breaks over the course of a 45 minute class, ending in tears in the bathroom because she couldn’t cope. She loved ballet.

And we had to give away our cat earlier in the year (Feb 2012) because M was afraid of her. (Though the cat, unfortunately, earned this reputation after many unprovoked incidences of biting, the last of which being M around Christmas 2011, right before all of this peeing stuff started…she’s now in a place where she can be who she is and still be loved. The cat. I mean the cat.)

And then she came down with some intense school avoidance and insanely tearful drop-offs.

That’s the low place we all were in when I bought this book.

Here’s why I love it (aside from the fact that it’s actually worked): the author provides so many examples based on her clinical experiences, that you either see your own child among them, or identify with where she will be at someday if you do not step in to help her get some coping skills. Anxiety runs on a spectrum, and it can ebb and flow over time (weeks/months/years), but no matter how strong or weak it is at any given point, people who have this tendency need additional tools to function in their daily life. Incidentally, anxiety also tends to run in families (though it can be in varying degrees or not quite the same issue among family members), so although there is certainly a genetic component that a child may have inherited in and of itself, if the parent(s) have any kind of anxious tendencies, that can lead to some not so healthy habits for everyone.

What’s more, what makes it even more challenging, is interacting with people who do not understand anxiety (so, for instance a third party like a teacher, or a non-anxious parent of an anxious child).  They do not understand how it is that the anxious person—no matter how intellectually smart or able to rationalize certain other things—cannot move past certain situations, at least not without coping skills/tools. This is why it is important for the anxious child to be able to live within society by using coping skills rather than run from it.

Thankfully, this book does the following:

• it approaches it from the perspective of instilling bravery among anxious or worried kids; it is positive, hopeful and optimistic that virtually any child can move forward no matter how entrenched some anxious habits may already be
• through myriad examples it explains for parents what is normal and what isn’t and when to do something about it (or not)
• it highlights certain types of anxiety and how each might be expressed by a child: separation anxiety disorder (it can occur later than you might think!), generalized anxiety disorder, specific phobias, obsessive-compulsive disorder, panic disorder, social phobia
• it identifies how parenting styles affect anxiety (this section was a HUGE eye opener for me…I was doing a lot wrong, basically by feeding the anxiety because I was reacting to my “sensing/sensitive/inquisitive” child with too much information all the time rather than more measured, matter of fact replies to my “worrier” child…an easy misstep to take)
• it explains the cycle of anxiety and how those thoughts work in the mind
• it provides practical strategies to start doing at home, school, etc. to move past whatever roadblock your child is up against, including a very specific way to  incorporate a 5-minutes a day with your child to encourage brave behavior and how to manage bedtime/night (a trigger for many anxious kids, younger and teenage alike)
• it teaches relaxation techniques, like breathing, even for the very young (who cannot use visualization techniques as well as older kids; this provides alternative approaches)
• it explains what to do about avoidant behaviors (through graduated exposures)
• and (the best part for us in this house) it gives guidance on how to use a “bravery ladder”

We are actually currently in the middle of a “bravery ladder” in our house.* We actually drew a ladder and are using stickers to chart progress (something we’ve never done before).  There are any number of ways you can do this, but here’s what M’s looks like (given her age, I drew the poster, but she is in charge of putting stickers on as they are achieved).

So, for the bedtime rituals that once involved me putting her to bed by having to lay next to her in her bed and then sneak out—remember, she’s 5.5  years old—I am happy to report that by using a bravery ladder, M is already at the point of where I just sit in a chair outside her room in the hallway, and she’s falling asleep within 5-10 minutes (without going to the bathroom literally every 6 minutes over the course of an hour or more before she fell asleep…that’s what our lowest point was). This has been achieved all since December 27th (can you tell this is a major deal in this house…so much so that I recall the date!) after more than 5 years of, well, let’s just say bad habits on everyone’s part.

You can see where we started. Baby steps is the key. You want to start with an easy first step, identify your end goal (last step) and then fill in graduated steps in between. You want to have early successes that lead to future confidence and bravery and, ultimately, success. The book even provides examples for some common scenarios. On M’s ladder, there was one step that seemed to be a little too much to manage one night, so we made a “half-step” rung along the way to make it easier. Obviously you want to stick to the ladder as you planned it out, but sometimes you need to leave a little room for flexibility.  Also, the child should be driving the momentum up the ladder at the pace that seems comfortable, but parents should certainly nudge/encourage along the way (but not too fast!) if kids get stuck at a certain spot. On M’s ladder, every time she reaches a new rung, she gets to put a smiley face sticker there, and along the way there are occasional rewards for bigger accomplishments (like my chair leaving the room was a big one…frozen yogurt date ensued).  The stars around the border are also keeping track of how many nights she has fallen asleep without anyone in the bed with her. Remarkable.

She’s still not at the top of the ladder yet, the point where I will just tuck her in and walk away to go downstairs, but the strides she has made in just under two months is stunning. Sure, the simultaneous professional help (UNmedicated, for those of you who are wondering) keeps us on track too since that is also based on CBT, but this book certainly could have helped us greatly even without that (I started the book at about the time she started getting assistance).

But we’re not stopping there. We already know the next ladder, and that is what happens when she wakes up in the middle of the night, which she does nightly. I won’t tell you what happens now, but the end point will be her getting herself asleep again all on her own without involving me.  But because of the successes she’s already had with other areas giving her anxiety, the idea is that all challenges will become easier for her over time, and take less time to overcome.  In other words, though it may take us ultimately three months to reach the top of this bravery ladder, the next one may take but one.

And really, success does breed success.  She’s in her 5th week of swimming lessons now (no potty breaks!), almost every school drop-off is tear free, she is using the bathroom at school with confidence, and she is friendly with the girl who initially caused some irrationally worrisome thoughts.  We are all in such a good, good place now.

I cannot stress enough how much this book is an outstanding resource for parents who have children with anxious tendencies. Whether it be the child who still struggles with school drop offs to the middle schooler who won’t go to a sleepover to the teenager who doesn’t want to ride the subway for fear of a panic attack, this book can help each of those families.

* M has made strides in two other areas with graduated exposures that did not use a “bravery ladder” of sorts (becoming friends with someone that was physically different from her in a way that triggered some anxiety/avoidant behaviors, and using the restroom in public places, particularly school) though each of these would have been good candidates for a ladder as well.  Usually, the trick is to find the issue that is most pressing for the child/family, and move forward through that first because, ideally, the other obstacles can be tackled with one success already achieved (success breeds success kind of thing), or often is the case where the other issues fall away on their own at the same time as whatever’s being conquered with the ladder.

Copyright (c) 2013 Kristen M. Ploetz