"There are monsters under my bed!"
"Turn the light on — it's too dark!"
Childhood fears are a nearly universal part of growing up. "It is normal for children, developmentally, to be very worried," says Dr. Victor Carrion, director of the Stanford Early Life Stress Research program at Lucile Packard Children's Hospital in Palo Alto, Calif. "They have very little control over their lives."
A phobia, however, is diagnosed when a child's irrational fear of something leads to the complete avoidance of it, causing functional impairment — and when that fear causes social, academic, or personal distress lasting at least six months.
If a parent or grandparent suspects a child is experiencing a phobia, they should first consult a pediatrician about what fears are normal for the child's particular developmental stage, advises Dr. Monique Breindel, a physician and parent in New York City, who adds, "I'd advise erring on the side of caution, which means speaking to some professional as soon as a fear becomes prominent or significant."
If the child really is experiencing a phobia, Breindel says, "Parents can see someone to get guidance on what they can do for the child at home. Most therapists will see parents, and with good primary-care support, the issue can often be dealt with at home."
Common childhood phobias
• Monsters — real and imagined. Some of the most common early childhood fears include fear of dogs, the dark, spiders — and monsters. Reading storybooks with a grandchild is a great way to start to tackle those fears, Carrion says. He recommends Maurice Sendak's Where the Wild Things Are (25th Anniversary edition, HarperCollins, 1988), because it shows that it's normal to have fears — and that they can be overcome.
• Needles, blood, and medical procedures. To help a child work through their fear of a medical procedure, even a simple shot, begin by gauging her temperament, Carrion advises. "Some don't want to know anything, and some want to know everything!" Follow the child's lead — if knowing every detail in advance will help her get through a procedure, tell her, although without too much gory detail.
• Separation and loss. Many young children fear being separated from their parents or homes. Sleeping over at a grandparent's house, Breindel says, can bring on separation anxiety and nighttime fears.
Carrion suggests that you talk about a grandchild's anxiety with her directly. Find out what she's afraid of and reassure her that you'll help her get through the visit.
(Interestingly, Carrion says most very young children — under the age of 7 or 8 — aren't necessarily afraid of death. As they get older, and grow to understand that death is universal and irreversible, they may come to develop a fear of it.)
How can grandparents help?
"Fear feeds on avoidance," Carrion says, so a trained practitioner might tackle a patient's debilitating phobia with "flooding," or throwing the person into the situation he or she fears. Another approach is behavior desensitization, which involves gradual exposure to the source of the fear. These techniques, however, require professional training and you should not try them on your own with your grandchildren.
But there are some approaches that the experts do encourage grandparents to try, especially because you may be well positioned to help a child deal with phobias. "You may have more time and patience to deal with the situation," Carrion says.
Relaxation or breathing exercises, for example, can be a helpful strategy for children with phobias. You can learn some basic techniques online or from a therapist. Visual imagery, in which you help a child imagine being in a place where he feels relaxed, can also help him get through an anxious time.
In most cases, you need not fear that a grandchild's fears will turn into lifetime phobias. "Children can get over these things," Carrion says, but not if parents and grandparents let a child's fears completely dictate his lifestyle and routines. "If we let their fear manage their exposure, that reinforces the fear."
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