Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states
"Good-night, good-night! parting is such sweet sorrow That I shall say good-night till it be morrow." Juliet to Romeo in act 2, scene 2 of Romeo and Juliet.
In the above Shakespearean quote, Juliet is proclaiming her love to Romeo and cannot wait until tomorrow when they will meet again. Children with separation anxiety disorder are also unable and unwilling to go to bed for fear of being away from their parents. However, the reasons for not wanting to be away from their parents are different in children than for Juliet in the famous play.
What is separation anxiety disorder and why does it occur?
First, it is important to understand that children go through a normal stage of separation anxiety. I always point out to friends and family that if their infant between the ages of 9 and twenty four months cry when the parent is away or when a stranger comes into the room it is a good thing. It is good because the crying is the result of anxiety when confronted by something new that could come between infant and mother. This is a development milestone because cognitive development has reached the level where the infant knows the difference between people who are familiar and people who are strangers. In addition, the infant recognizes what is familiar and what is unfamiliar in their environment.
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When children first begin going to school they may experience some separation anxiety as they adjust to being away from home and parents for the first time.
Separation Anxiety Disorder becomes a serious problem when it interferes with the ability of the child to go to school, bed or anywhere new or without the parent.
Symptoms of Separation Anxiety Disorder (Diagnostic and Statistical Manual IV:
1. Recurrent distress and worry when separation from home and parents is expected.
2. Persistent worry that something terrible will happen to parents when there is a separation.
3. Refusal to go to school for fear of being away from home and parents.
4. Refusal to go to bed out of fear of loss of or separation from parents.
5. Following parents around from one room to the next for fear of separation and being alone.
6. Constant complaints about headaches, stomach aches, nausea, vomiting, etc. when separation is expected.
In addition, these problems last for at least four weeks and interfere with the child’s ability to function at school with regard to learning and socializing.
Problems with Diagnosis:
A. Younger children do not talk about or verbally express their fears and anxieties. Therefore, it is important that parents be alert to the types of symptoms listed above. If there is any doubt then parents should seek an evaluation and diagnosis of their child.
B. It can be difficult to diagnose separation anxiety disorder because there is overlap with other anxiety disorders. For example, social phobia or the fear of being with other children can be confused with separation anxiety. Then, too, a stressful event can cause any child or adult to become anxious. It is not the temporary presence of anxiety that is the problem. Rather, it is the fact that the anxiety persists and or weeks or months that indicates there is a problem.
C. There are many reasons why a child mght refuse to go to schoo that have nothing to do with separation anxiety. For instance, a bully at school who is threatening a child will most definitely discourage the youngster from wanting to go.
Why Does Separation Anxiety Disorder Occur?
It is not clear why separation anxiety disorder occurs. Research shows that anxiety disorders run in families so that there is a genetic component. In addition, children and adolescents who experience separation anxiety disorder often go on to develop other types of anxiety disorders during adulthood. In addition, separation anxiety disorder can and does plague some adults and not only younger people.
John Bowlby was the psychiatrist who did a lot of work in the area of attachment. According to attachment theory anxiety disorders have a lot to do with the parenting experiences children have with their mother. Those children who learn that their mother is reliable form secure attachments and those children who learn that their mother is not reliable develop anxious attachments.
Whether you agree with Bowlby or not one of the clues to helping youngsters with separation anxiety disorder does lie in this theory.
Treatment for Separation Anxiety Disorder:
It is important that children and adolescents not be ignored if they are experiencing this disorder because of the way it interferes with their lives and the probability that other anxiety disorders will develop.
1. Cognitive and Behavioral Therapies are important in treating separation anxiety disorder.
A. cognitive therapy helps children address and correct the fearful and unrealistic thoughts about separation from family.
B. behavioral therapy is used to desensitize and accustom the child or adolescent to separation from home.
2. Family Therapy is important in helping parents learn how to reassure their child that they are reliable and will be present and available after the separation has ended.
Please E. Mail us about questions or experiences with separation anxiety disorder.
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